【摘要】 目的　评价在 2型糖尿病患者中测定尿铜蓝蛋白 (Cp)的临床意义。方法　取 143例正常人和 396 0例次 2型糖尿病患者晨尿 ,同时测定尿白蛋白 /肌酐 (Alb/Cr)和Cp/Cr,Alb测定用放免法 ,Cp测定用ELISA法。结果　 (1) 134例正常人尿Cp/Cr值范围为 0 0 1～ 1 12ng/mmol,中位数为0 36ng/mmol。Cp/Cr>0 92 4ng/mmol可考虑测试结果异常 ,男性与女性之间晨尿Cp/Cr无统计学差异 ,Cp/Cr与年龄不相关。正常人群晨尿Cp/Cr与Alb/Cr呈正相关。 (2 )以Alb/Cr≥ 2 5mg/mmol为早期糖尿病肾病的诊断标准。 2型糖尿病病人晨尿Cp/Cr的敏感性为 90 %,特异性为 6 6 %,符合率为73 6 %,Kappa值为 0 4 8,Cp/Cr与Alb/Cr正相关 ,运动后Cp/Cr升高 ,而Alb/Cr无明显改变。结论　晨尿Cp/Cr可能为诊断 2型糖尿病早期肾脏病变的标准之一 ,且较尿Alb/Cr更为敏感。更多还原

【Abstract】 Objective To evaluate the clinical significance of detection of urinary ceruloplasmin (Cp) in type 2 diabetes. Methods To measure albumin/creatinine(Alb/Cr) and Cp/Cr in morning urinary specimens, from 134 normal controls and 3 960 diabetes, with RIA and ELISA separately. Results (1) The range of urinary Cp/Cr for normal controls was 0.01～1.12 ng/mmol, median 0.36 ng/mmol. Cp/Cr>0.924 ng/mmol was considered as abnormal, and there was no significant difference between males and females, as well as among subjects of different age. (2) The sensitivity and specificity of Cp/Cr were 90% and 66% respectively with Alb/Cr>2.5 mg/mmol as a golden standard for diabetic nephropathy, and Kappa value 0.48. Urinary Cp/Cr correlated well with Alb/Cr. (3)After sub-maximal exercise, Cp/Cr elevated markedly with no significant change of Alb/Cr. Conclusion Urinary Cp/Cr could be considered as a marker of diabetic nephropathy and might be more sensitive than Alb/Cr.更多还原