2型糖尿病患者肾小管功能的改变

摘要

目的　观察2型糖尿病患者肾小管功能的改变。方法　对45例2型糖尿病患者的尿酸化功能、视黄醇结合蛋白(RBP)及渗透压进行了检测。结果　①2型糖尿病患者尿中可滴定酸(TA)、铵离子(NH＋4)、净酸排泄量(NAC)及尿渗透压均显著低于正常对照(P＜0.05，P＜0.01)。尿RBP排泄量则明显高于正常对照(P＜0.01)。②这些肾小管功能异常在肾小球滤过功能尚未明显受损时即已出现，并随肾小球病变加重而更趋显著。结论　2型糖尿病患者肾小管损害亦相当常见，它在糖尿病肾病(DN)的发生发展中起着与肾小球病变同样重要的作用%Objective To investigate the changs of renal tubular function in type 2 diabetes mellitus.Methods Urinary acidification,retinol-binding protein(RBP),and osmolity were measured in 45 patients with type 2 diabetes mellitus.Results ①TA，NH＋4NAC,and osmolity in the urine of type 2 diabetic patients were significantly lower than normal(P＜0.05，P＜0.01).The excretion of urinary RBP increased remarkably in comparison with that in normal controls(P＜0.01.②Renal tubular dysfunction occurred before the glomerular filtrating function decreased and augmented with the glomerular lesions deterioration.Conclusion Renal tubular damages are rather common in type 2 diabetes mellitus and they may play a similar part in the development of diabetic nephropathy as glomerular lesions.