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目的:研究糖尿病患者的血浆D-二聚体及尿N-乙酰-β-D氨基葡萄糖苷酶(NAG)、尿微量白蛋白(mAlb)与糖尿病早期肾损伤的关系。方法:对糖尿病患者进行大范围社区普查,其中1437例糖尿病患者且尿常规蛋白检测阴性者分别检测尿NAG、mAlb,再从中随机选取30例尿NAG大于11.5 U/L、mAlb大于30 mg/L,30例尿NAG小于11.5 U/L、mAlb小于30 mg/L糖尿病患者检测血浆D-二聚体,同时选30例健康正常人作为对照。结果:尿NAG、mAlb水平在糖尿病组和健康对照组之间的差别均有统计学意义(P<0.05),两者联合诊断阳性率19.82%。血浆D-二聚体在尿NAG、mAlb水平都高于检测限和都低于检测限两组的水平与对照组相比差别有统计学意义(P<0.05)。结论:联合检测尿NAG、mAlb、血浆D-二聚体可早期发现糖尿病肾损伤,为临床医生及时采取治疗措施提供有力的实验证据。
Objective: To investigate the relationship between plasma D-dimer and urinary N-acetyl-β-D-glucosaminidase (NAG), urinary microalbumin (mAlb) and diabetic nephropathy in diabetic patients. Methods: A large-scale community survey was conducted on diabetic patients. Urine NAG and mAlb were detected in 1437 diabetics with negative urinalysis, and 30 urine samples with NAG> 11.5 U / L and mAb> 30 mg / L 30 cases of urine NAG less than 11.5 U / L, mAlb less than 30 mg / L in patients with diabetes mellitus detection of plasma D-dimer, while 30 healthy subjects were selected as controls. Results: The differences of urinary NAG and mAlb levels between the diabetic group and the healthy control group were statistically significant (P <0.05). The positive rate of combined diagnosis was 19.82%. Plasma D-dimer in urine NAG, mAlb levels are higher than the detection limit and are lower than the detection limit of the two groups compared with the control group, the difference was statistically significant (P <0.05). Conclusion: Combined detection of urinary NAG, mAlb and plasma D-dimer can detect diabetic renal injury early and provide strong experimental evidence for clinicians to take timely treatment.