联合尿N―乙酰―β―D―氨基葡萄糖苷酶与尿血渗透压比测定在糖尿病肾病早期诊断中价值.docVIP

联合尿N―乙酰―β―D―氨基葡萄糖苷酶与尿血渗透压比测定在糖尿病肾病早期诊断中价值 　　【摘要】 目的：评价联合尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）与尿/血渗透压比测定在糖尿病肾病早期诊断中的价值。方法：2型糖尿病患者150例，按尿白蛋白排泄率（UAER）分为A组65例（UAER20 μg/min），B组54例（20 μg/min≤UAER200 μg/min），C组31例（UAER≥200 μg/min），正常对照组30例，测定血、尿渗透压、尿/血渗比及尿NAG，并比较。结果：（1）相关分析显示，尿NAG与病程、UAER、BUN、年龄呈显著正相关（r=0.296、0.424、0.247、0.266，P0.01），与HbA1c、尿糖、血肌酐亦呈正相关（r=0.217、0.205、0.245，P0.05）；尿/血渗比与病程、UAER、血肌酐、年龄呈显著负相关（r=-0.259、-0.371、-0.252、-0.282，P0.01），与HbA1c呈负相关（r=-0.227，P0.05），与GFR呈正相关 　　（r=0.200，P0.05）。（2）A、B、C各组与对照组尿NAG及尿/血渗比差异均存在统计学意义（P0.05）。结论：联合尿NAG与尿/血渗比测定可全面评估肾小管功能，有助于糖尿病肾病的早期诊断。 　　【关键词】 糖尿病肾病； N-乙酰-β-D-氨基葡萄糖苷酶； 尿/血渗透压比值 　　【Abstract】 Objective： To evaluate the value of combined with urine to blood osmolality ratio and urinary N-acetyl-β-D-glocosaminidase （NAG） in early diagnose of diabetic nephropathy. Method： A total of 150 patients with type 2 diabetes mellitus were divided into three groups including group A （UAER20 μg/min， 65 cases）， group B （20 μg/min≤UAER200 μg/min， 54 cases）， and group C （UAER≥200 μg/min， 31 cases）. 30 healthy subjects were enrolled as the control group. The blood-urinary osmolality and urinary NAG were determined， which were compared between the three groups. Result： （1） Correlation analysis showed that urinary NAG was positively correlated with course， UAER， BUN， age （r=0.296，0.424，0.247，0.266，P0.01）， HbA1c， urine-glucose， and creatinine （r=0.217，0.205，0.245，P0.05）. Urine to blood osmolality ratio was negatively correlated with disease course， UAER， serum creatinine， age （r=-0.259，-0.371，-0.252，-0.282，P0.01）， HbA1c （r=-0.227，P0.05）， but positively GFR （r=0.200，P0.05）. （2） There were significant differences between the three groups in urinary NAG and urine to blood osmolality ratio （P0.05）. Conclusion： Urinary NAG combined with urine to blood osmolality ratio contribute to complete assessment the renal tubular function， and is conducive to the early diagnosis of diabetic nephropathy. 　　【Key words】 Diabetic nephropathy； N-acetyl-β-D-glocosaminidase； Urinary t