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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。
Objective To evaluate the clinical significance of determining urinary ceruloplasmin (Cp) in type 2 diabetic patients. Methods Morning urine was measured in 143 normal subjects and 3960 patients with type 2 diabetes mellitus. Urinary albumin / creatinine (Alb / Cr) and Cp / Cr were measured simultaneously. Alb was determined by radioimmunoassay and Cp was determined by ELISA. Results (1) The urine Cp / Cr values of 134 normal subjects ranged from 0 to 1 12 ng / mmol, with a median of 0 36 ng / mmol. Cp / Cr> 0 92 4 ng / mmol Consider the test results abnormalities, morning and afternoon urinary Cp / Cr between men and women no significant difference, Cp / Cr age-independent. The normal people morning urine Cp / Cr and Alb / Cr was positively correlated. (2) Alb / Cr ≥ 25mg / mmol for the early diagnosis of diabetic nephropathy. The sensitivity and the specificity of Cp / Cr in morning urine of type 2 diabetic patients were 90%, 66%, 73 6%, Kappa value of 0 48, and Cp / Cr were positively correlated with Alb / Cr after exercise / Cr increased, while Alb / Cr no significant change. Conclusions Morning urine Cp / Cr may be one of the diagnostic criteria for early stage renal disease in type 2 diabetic patients and is more sensitive than urine Alb / Cr.