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目的探讨视黄醇结合蛋白(RBP)与胱抑素C(Cys-C)水平对2型糖尿病肾病(T2DMN)的早期诊断价值。方法对116例T2DMN患者(DN组)及38例健康者(C组)分别测定尿蛋白排泄率(UAER)、RBP、Cys-C、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)及尿微量白蛋白(mAlb)指标。Cys-C、RBP及UAER、mAlb的测定均采用免疫比浊分析法,NAG的测定采用化学酶法速率法。结果DN组血RBP、尿RBP、Cys-C、NAG含量显著高于C组(P<0.05),且各检测指标水平在不同的T2DMN临床分期间均有统计学差异(P<0.05)。T2DMN早期患者尿RBP阳性检出率高达56.84%。结论尿RBP可以作为反映T2DM患者肾脏早期损伤灵敏、可靠的实验室指标;尿RBP与Cys-C同时检测可作为评价肾功能受损程度及部位的指标。
Objective To investigate the early diagnostic value of retinol binding protein (RBP) and cystatin C (Cys-C) in type 2 diabetic nephropathy (T2DMN). Methods Urine protein excretion rate (UAER), RBP, Cys-C, N-acetyl-β-D-glucosaminidase (NAG) were measured in 116 patients with T2DMN and 38 healthy controls, And urinary microalbumin (mAlb) indicators. Cys-C, RBP and UAER, mAlb were determined by immunoturbidimetric assay, NAG assay using chemical enzymatic rate method. Results The contents of RBP, urinary RBP, Cys-C and NAG in DN group were significantly higher than those in C group (P <0.05), and the levels of each index were statistically different between different clinical stages of T2DM (P <0.05). Urine RBP positive rate of early patients with T2DMN up to 56.84%. Conclusions Urinary RBP can be used as a sensitive and reliable laboratory indicator of early renal damage in T2DM patients. Simultaneous detection of urinary RBP and Cys-C can be used as an index to evaluate the degree and location of renal dysfunction.