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目的通过检测2型糖尿病(T2DM)患者的N-乙酰-β-D氨基葡萄糖苷酶(NAG)、尿微量白蛋白(尿mAlb)、α-微球蛋白(α1-MG)和转铁蛋白(TRF)水平的变化情况,探讨三者联合检测在糖尿病肾病诊断中的重要意义。方法选取2型糖尿病患者93例,分为血糖控制不良组41例、血糖控制良好组52例;健康对照组60例作为正常对照组。采用对硝基酚比色法测定尿NAG,采用免疫透射比浊法测定尿mAlb、α1-MG、TRF,采用微柱法测定糖化血红蛋白HbA1C。结果 T2DM组、血糖控制不良组、血糖控制良好组较正常对照组,血糖控制良好组较血糖控制不良组,NAG、尿mAlb、α1-MG和TRF水平差异有统计学意义(P<0.01)。单项或联合检测NAG、尿mAlb两者的阳性率均较高;常规尿蛋白测定的敏感性大大低于NAG等指标的单项或联合检测。结论 NAG可以作为诊断2型糖尿病的重要指标,联合检测NAG、尿mAlb、α1-MG和TRF水平对诊断该病具有重要意义。
OBJECTIVE: To investigate the role of N-acetyl-β-D-glucosaminidase (NAG), urinary microalbuminuria (mAlb), α-microglobulin (α1-MG) and transferrin in patients with type 2 diabetes mellitus (T2DM) TRF) levels in patients with diabetic nephropathy, and to explore the significance of the combined detection of the three in the diagnosis of diabetic nephropathy. Methods Ninety-three patients with type 2 diabetes mellitus were selected and divided into 41 cases with poorly controlled glycemic control and 52 cases with well-controlled glycemia. Sixty healthy control subjects served as normal control subjects. Urinary NAG was measured by nitrophenol colorimetric method. Urinary mAlb, α1-MG and TRF were measured by immunoturbidimetry. HbA1C was determined by microcolumn method. Results There was significant difference between T2DM group, poor glycemic control group, good glycemic control group and normal control group, poor glycemic control group, NAG, urinary mAlb, α1-MG and TRF levels (P <0.01). Single or combined detection of NAG, urine mAlb positive rate of both are higher; conventional urine protein sensitivity was significantly lower than NAG and other indicators of single or combined testing. Conclusion NAG can be used as an important index in the diagnosis of type 2 diabetes. The combined detection of NAG, urine mAlb, α1-MG and TRF levels is of great significance for the diagnosis of the disease.