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目的 以尿微量白蛋白排泄率为参照 ,对比检测尿铜蓝蛋白的排泄情况 ,以了解其在青少年 1型糖尿病肾病早期检测中的价值。方法 青少年 1型糖尿病患者 4 0例 ,肾病综合征对照 2 1例 ,正常青少年对照 6 0例 ,收集 2 4h尿液。放免法测定尿微量白蛋白 ,ELISA法测定尿铜蓝蛋白。结果 糖尿病和肾病综合征组尿微量白蛋白、铜蓝蛋白较正常对照显著增加 (P <0 .0 5 ) ,糖尿病患者尿铜蓝蛋白排泄异常者占 4 7.5 % ,尿微量白蛋白异常者占 10 % ,尿铜蓝蛋白随病程增高的幅度大于尿微量白蛋白增高的幅度。尿铜蓝蛋白与尿微量白蛋白、HbA1c显著正相关。结论 尿铜蓝蛋白可能是反映青少年 1型糖尿病患者早期肾损害的更为灵敏的指标。
Objective To compare urinary ceruloplasmin excretion with urine microalbumin excretion rate to find out its value in the early detection of adolescent type 1 diabetic nephropathy. Methods Twenty-four adolescents with type 1 diabetes, 21 controls with nephrotic syndrome and 60 controls with normal controls were recruited. Urine was collected for 24 hours. Urinary microalbuminuria was determined by radioimmunoassay and urine ceruloplasmin by ELISA. Results The urinary microalbumin and ceruloplasmin in diabetic and nephrotic syndrome group were significantly higher than those in normal control group (P <0.05). The urinary ceruloplasmin excretion was abnormal in patients with diabetes mellitus (7.57%), and the abnormal microalbuminuria 10%, urinary ceruloplasmin increased with the course of the magnitude of urine microalbumin increased amplitude. Urinary ceruloplasmin and urine microalbumin, HbA1c was significantly correlated. Conclusion Urinary ceruloplasmin may be a more sensitive indicator of early renal impairment in adolescents with type 1 diabetes.