摘要
目的探讨联合检测尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）和血半胱氨酸蛋白酶抑制剂C（CystatinC）对糖尿病肾病（DN）早期诊断的临床意义。方法62例2型糖尿病患者（糖尿病组）根据24h尿白蛋白排泄量（24hUAE）分为三组，A组（正常白蛋白尿组，24hUAE〈30mg）20例；B组（微量白蛋白尿组，24hUAE30～300mg）22例；C组（大量自蛋白尿组，24hUAE〉300nag）20例。另选择30例健康人作为对照组。收集并测定各组24hUAE、尿NAG活性，同时检测血清肌酐（SCr）及Cystalin C、采用Coekcroft—Gault公式计算内生肌酐清除率（Ccr），比较各组上述指标的变化。结果糖尿病组尿NAG活性、血清CystatinC水平均较对照组明显升高（P〈0．01），Ccr显著降低（P〈0．01）；尿NAG活性、血清CystatinC水平在糖尿病分组问逐渐升高（P〈0．05或〈0．01），而SCr增高在A组、B组差异无统计学意义（P〉0．05）。糖尿病组尿NAG活性、血清CystatinC、24hUAE、SCr两两比较差异均有统计学意义，呈正相关（P〈0．01），与Ccr均呈显著负相关（P〈0．01）。尿NAG活性和血清CystatinC联合检测阳性率（80．6％，50／62）高于单项检测阳性率[分别为58．1％（36／62）和61．3％（38／62）]（P〈0．05）。结论尿NAG和血清CystatinC是反映DN的敏感指标，联合检测可提高DN早期损害的检出率，有利于早期诊断。
Objective To explore the value of combined measurement of urine N-acetyl-beta-D- glucosaminidase （NAG） activity and serum Cystatin C in diagnosing dialectic nephropathy （DN） in early phase. Methods Sixty-two cases with type 2 diabetes （diabetic group） were divided into three groups according to their 24 hours urinary albumin excretion （24hUAE） ：group A （normal albuminuria, 20 cases ）, group B （microalbuminuria, 22 cases ） and group C （macroalbuminuria, 20 cases ）. Furthermore, 30 healthy people were involved in control group. 24hUAE, NAG, serum creatinine （SCr） and serum Cystafin C were measured, and endogenous creatinine clearance rate （Ccr） was calculated by Cockcroft-Gault formula. All these indexes among three groups were compared. Results The levels of urinary NAG activity and serum Cystatin C in diabetic group was significantly higher and Ccr was significantly lower than those in control group（P 〈 0.01 ）. The levels of urinary NAG activity and serum cystatin C gradually increased in group A, B and C（P〈 0.05 or 〈 0.01 ）. While no significant difference was observed between group A and group B in the level of SCr （P 〉 0.05 ）. There were significant positive correlations among the levels of urinary NAG activity, serum Cystatin C,24hUAE and SCr （P 〈 0.01 ）,and all above showed negative correlations with Ccr （P 〈 0.01 ）. Co-detection of urinary NAG activity and serum Cystatin C had significantly higher positive rate [80.6%（50/62）] than singleone [58.1%（36/62）,61.3%（38/62）]（P〈0.05）. Conclusion Co-detection of urinary NAG activity and serum Cystatin C may indicate early renal damage in DN, and it is valuable in diagnosing DN in early phase.
出处
《中国医师进修杂志》
2010年第7期22-24,共3页
Chinese Journal of Postgraduates of Medicine
