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临床上糖尿病肾病变(CDN)是依据蛋白尿试验(Albustix 法)阳性而确诊,蛋白尿≥0.5g/24h 是肾小球功能进行性降低的最早标志,几年后会导致肾功能衰竭。进行性肾功能衰竭一经发生就难以治疗,并且实际上不可逆转。在糖尿病初期,患者的肾脏就已发生了异常,其中包括尿蛋白排泄率(AER)升高(微蛋白尿),但是 AER 升高只能用敏感的尿蛋白测定方法才能检出。在这个阶段用 Albustix 法测定尿蛋白往往阴性,并且用标准的临床试验测定肾功能也在正常范围。作者报告1组胰岛素依赖型糖尿病患者的肾功能(包括 AER)和14年后随访研究的结果,旨在判断在筛选检查时有否一种特性试验对临床蛋白尿或肾功能衰竭的发生有预测价值。
Clinically, diabetic nephropathy (CDN) is diagnosed on the basis of a positive proteinuria test (Albustix’s method). Proteinuria ≥0.5g / 24h is the earliest sign of progressive glomerular dysfunction and leads to renal failure after a few years. Progressive renal failure is untreatable once it occurs and is virtually irreversible. In the early stages of diabetes, the patient’s kidneys have been abnormal, including elevated urinary protein excretion (microalbuminuria), but elevated AER can only be detected using a sensitive urinary protein assay. Urinary proteins are often negative at this stage using the Albustix method, and renal function is also within the normal range as measured by standard clinical trials. The authors report on the renal function (including AER) and the results of a 14-year follow-up study in a group of patients with insulin-dependent diabetes mellitus to determine whether there is a predictor of clinical proteinuria or renal failure at screening screening value.