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目的 通过测定尿肾小管间质标志蛋白以探讨 2型糖尿病患者肾小管间质病变。方法 同期测定 2 15例 2型糖尿病 2 4小时尿白蛋白 (2 4h UAE)、视黄醇结合蛋白 (RBP)、α1 -微球蛋白 (α1 - MG)、β2 -微球蛋白 (β2 - MG)、Tamm-Horsfall糖蛋白 (THP)、尿糖 (UG)和肌酐清除率 (Ccr)。结果 12 15例 2型糖尿病患者 2 4h URBP、2 4h Uα1 - MG和2 4h Uβ2 - MG增高的发生率分别为 39.5 %、45 .1%、34.4% ,且其排泄增高的发生率均随 2 4h UAE的增加而增高 ;2 4hTHP排泄降低的发生率为 40 .0 % ;2在微量和大量白蛋白尿患者中 ,2 4h Uα1 - MG增高亚组与正常亚组比较 ,Ccr明显降低 ,P<0 .0 5 ;3 2 4h URBP、2 4h Uα1 - MG、2 4h Uβ2 - MG和 2 4h UTHP排泄与 2 4h UG无相关性。结论 2型糖尿病肾脏病变除肾小球病变之外 ,肾小管间质病变亦相当常见 ,甚至早于肾小球病变 ,并参与肾功能的损害
Objective To investigate the tubulointerstitial lesions in type 2 diabetic patients by measuring urinary tubulointerstitial marker protein. Methods Two hundred and seventy - two cases of type 2 diabetes mellitus (24 hours UAE), RBP, α1 - MG and β2 - microglobulin (β2 - MG) ), Tamm-Horsfall glycoprotein (THP), urine sugar (UG) and creatinine clearance (Ccr). Results The incidences of URBP, 2 4h Uα1 - MG and 24h Uβ2 - MG in 12 15 patients with type 2 diabetes mellitus were 39.5%, 45.1% and 34.4%, respectively. The incidence of excretion increased with the increase of 2 4h UAE increased, while the rate of 24hTHP excretion decreased 40.0%. 2 In the micro and macroalbuminuria patients, the 24 h Uα1 - MG increased subgroup compared with the normal subgroup, Ccr decreased significantly, P There was no correlation between urinary excretion of 24 h Uα1 - MG, 24 h Uβ2 - MG and 24 h UTHP and 24 h UG. Conclusions In addition to glomerular lesions in type 2 diabetic nephropathy, tubulointerstitial lesions are quite common and even precede glomerular lesions and are involved in the impairment of renal function