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的价值

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（UAER<20µg/min），B组54例（20µg/min≤UAER<200µg/min），C组31例（UAER≥200µg/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，P<0.01），与HbA1c、尿糖、血肌酐亦呈正相关（r=0.217、0.205、0.245，P<0.05）；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，P<0.01），与HbA1c呈负相关（r=-0.227，P<0.05），与GFR呈正相关（r=0.200，P<0.05）。（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（P<0.05）。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。%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 (UAER<20 µg/min, 65 cases), group B(20 µg/min≤UAER<200 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,P<0.01), HbA1c, urine-glucose, and creatinine (r=0.217, 0.205,0.245,P<0.05). Urine to blood osmolality ratio was negatively correlated with disease course, UAER, serum creatinine, age (r=-0.259,-0.371,-0.252,-0.282,P<0.01), HbA1c (r=-0.227,P<0.05), but positively GFR (r=0.200,P<0.05). (2) There were significant differences between the three groups in urinary NAG and urine to blood osmolality ratio (P<0.05).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.