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目的探讨尿微量白蛋白(MA)、尿转铁蛋白(TRF)、尿β2-微球蛋白(β2-MG)和尿α1-微球蛋白(α1-MG)在糖尿病肾病早期诊断中的意义。方法采用免疫比浊法测定82例2型糖尿病患者及80名健康人24h尿中MA、TRF、β2-MG、α1-MG含量,比较四者在糖尿病肾病筛选中的价值。结果糖尿病病程小于5年组,尿24hα1-MG、β2-MG含量与健康对照组相比明显增加;糖尿病病程5～10年组,尿24hMA、TRF、β2-MG和α1-MG含量与健康对照组相比明显增加;在尿微量白蛋白正常的糖尿病患者中,尿24hTRF、β2-MG和α1-MG含量增高的百分比分别为29.23%,50.77%,61.54%。结论糖尿病肾病早期肾小球和肾小管都有-定程度的损害,尿TRF、β2-MG和α1-MG较尿MA出现更早,测定尿TRF较尿MA更敏感,测定尿TRF、α1-MG、β2-MG和MA,有助于全面评估糖尿病肾病(DN)的肾损害,早期诊断DN。
Objective To investigate the significance of urinary albumin (MA), urinary transferrin (TRF), urinary β2-microglobulin (β2-MG) and urinary α1-microglobulin (α1-MG) in the early diagnosis of diabetic nephropathy. Methods The contents of MA, TRF, β2-MG and α1-MG in urine of 82 patients with type 2 diabetes mellitus and 80 healthy people were measured by immunoturbidimetry. The value of these four in the screening of diabetic nephropathy was compared. Results The duration of diabetes was less than 5 years, urinary 24hα1-MG and β2-MG levels were significantly increased compared with the healthy control group. Urine 24hMA, TRF, β2-MG and α1-MG in the 5 ~ In the group of normal urine microalbuminuria, the percentage of urinary 24hTRF, β2-MG and α1-MG increased by 29.23%, 50.77% and 61.54% respectively. Conclusions Early glomeruli and tubules of diabetic nephropathy have a certain degree of damage, urinary TRF, β2-MG and α1-MG appear earlier than urine MA, urinary TRF was measured more sensitive than urine MA, urine TRF, α1- MG, β2-MG and MA contribute to a comprehensive assessment of renal damage in diabetic nephropathy (DN) and early diagnosis of DN.