摘要:
目的:探讨十二烷基硫酸钠-琼脂糖凝胶(sodium dodecyl sulfate agarose gel electrophore-sis, SDS-AGE)尿蛋白电泳检测在糖尿病(diabetes mellitus, DM)早期肾损伤中的诊断价值。方法选择我院132例2型糖尿病(type 2 diabetes mellitus, T2DM)患者,根据尿蛋白定性检测结果进行分组,其中尿蛋白定性Pr(-)组65例,Pr(+/-)组32例,Pr(1+)组16例,Pr(2+)组10例,Pr(3+)组9例,选取同期健康体检者30例作为对照组。对受试者进行SDS-AGE尿蛋白电泳、24 h尿白蛋白定量(24 hours-al-bumin,24 h-Alb)、血清肌酐(serum creatinine, SCr)、尿素氮(blood urea nitrogen, BUN)水平检测,对检测结果进行统计学分析。结果132例T2DM患者中有45例为生理性蛋白尿(45/132,34.1%),15例蛋白尿阴性(15/132,11.4%),72例患者出现病理性蛋白尿(72/132,54.5%),其中混合性蛋白尿29例(29/132,22.0%),肾小管性蛋白尿25例(25/132,18.9%),肾小球性蛋白尿18例(18/132,13.6%)。132例T2DM 患者中,SCr、BUN、24 h-Alb、SDS-AGE 尿蛋白电泳检测的阳性率分别为5.3%(7/132)、24.2%(32/132)、41.7%(55/132)和54.5%(72/132)。在不同尿蛋白定性组中,SCr、BUN、24 h-Alb定量、尿蛋白电泳的检测阳性率均随尿蛋白含量的增加呈上升趋势。SDS-AGE尿蛋白电泳检测DM患者肾脏损伤程度的阳性率高于SCr、BUN及尿24 h-Alb定量的阳性率,且差异均有统计学意义(P均<0.05)。结论SDS-AGE尿蛋白电泳检测可直观的了解患者尿蛋白的组分,判断肾脏损伤的部位及程度,对DM患者早期肾损伤有预测价值。%Objective To study the diagnostic value of urine protein sodium dodecyl sulfate agarose gel electrophoresis (SDS-AGE) detection in the early renal damage of patients with diabetes mellitus (DM). Methods 132 cases type 2 diabetes mellitus(T2DM) patients in our hospital were collected and were divided into Pr(-) group 65 cases, Pr(+/-) group 32 cases, Pr(1+) group 16 cases, Pr(2+) group 10 cases, Pr(3+) group 9 cases according to the qualitation results of urine protein. 30 cases healthy people were collected as the control group. The SDS-AGE urine protein electrophoresis, 24 h urine albumin (24 h-Alb) quantitative, serum creatinine (SCr) and blood urea nitrogen (BUN) of all the subjects were detected, and the results were analyzed statistically. Results In 132 cases T2DM patients, there were 15 cases (15/132, 11.4% ) proteinuria negative, 45 cases (45/132, 34.1%) physiologic proteinuria, and 72 cases (72/132, 54.5%) pothological proteinuria which including 29 cases (29/132, 22.0%) miscellaneous proteinuriam, 25 cases (25/132, 18.9%) tubular proteinuria and 18 cases(18/132, 13.6%) glomerular proteinuria. The positive rate of SCr, BUN, 24 h-Alb and SDS-AGE urine protein electrophoresis in 132 cases T2DM patients were 5.3%(7/132), 24.2%(32/132), 41.7%(55/132) and 54.5%(72/132), respectively. The positive rate of SCr, BUN, 24 h-Alb and SDS-AGE urine protein electrophoresis showed a increasing trend along with the urine protein quantity. The positive rate of SDS-AGE urine protein electrophoresis was higher than that of SCr , BUN, 24 h-Alb, and the differences all had statistical significance (Pall<0.05). Conclusion SDS-AGE urine protein electrophoresis can reflect urinary protein components of DM patients intuitively , and judge the position and degree of kidney damage, which has early prediction value for the early renal damage in the patients with DM.