【摘要】 目的　探讨 2型糖尿病患者早期肾小管损伤标志物尿视黄醇结合蛋白 (RBP)、N 乙酰 β D 葡萄糖苷酶(NAG)的变化及临床意义。方法　采用ELISA方法测定 79例 2型糖尿病患者尿RBP的含量 ,用比色法测定尿NAG的含量 ,并用多元回归分析糖尿病患者尿RBP、NAG水平与病程、年龄、血糖、血脂、血肌酐及尿白蛋白 (Alb)之间的关系。结果　 2型糖尿病患者尿RBP、NAG排出增多 ,其升高的阳性率分别为 5 0 .6 %、5 8.2 % ,尿Alb增高的阳性率为36 .8% ,尿β2 微球蛋白 (β2 M)升高者占 30 .4 % ,尿RBP、NAG与糖化血红蛋白 (HbA1c)、尿Alb、血肌酐及血脂呈正相关 ,与年龄、病程、体重指数及血压无关。结论　糖尿病肾病早期既存在肾小球亦存在肾小管功能损伤 ,甚至在有些患者 ,肾小管功能损害早于肾小球。对糖尿病患者应重视肾小管功能损伤 ,早期控制糖尿病的糖、脂代谢紊乱 ,保护肾脏功能。更多还原

【Abstract】 Objective To observe the changes of urinary retinol-binding protein(RBP) and N-acetyl-D glucosaminidase (NAG)in type 2 diabetes and investigate the factors influencing renal tubular functions.Methods The urinary content of RBP,NAG as markers of the tubular damage were examined.Meanwhile,the correlation between disease course,age,HbA 1c,triglyceride(TG),cholesterol(Cho),urinary albumin(Alb) and RBP,NAG was judged by pluralistis analysis.Results An increasing urinary excretion of RBP,NAG,Alb, β 2-M occurred during the early stage of diabetes,at the rate of 43.1%, 58.2%, 36.8%, 30.4% respectively.Urinary RBP and NAG correlated with HbA 1c,Alb,serum creatinine.Conclusions Coexsistance of glomerular and tubular damage is shown in the early stage of diabetes mellitus.These findings suggested that proximal tubular dysfunction precedes some glomerular dysfunctions.RBP and NAG are early sensitive markers of diabetic nephropathy(DN).It is beneficial to prevent from DN in correcting the metabolic parameters early.更多还原