中文摘要：

目的 探讨糖尿病肾病（DN）患者尿液中性粒细胞明胶酶相关载脂蛋白（NGAL）、肾损伤分子- 1（KIM-1）的水平变化及意义.方法 选择在我院治疗的2型糖尿病（T2DM）患者70例,根据尿清蛋白/肌酐比值（albumin-to creatinine ratio,ACR）分为正常清蛋白尿组（NA组）28例、微量清蛋白尿组（MI组）22例、大量清蛋白尿组（MA组）20例;同期选取23例非糖尿病、非肾脏病患者作为对照组.应用ELISA法检测4组患者尿液NGAL、KIM-1的水平并比较,同时分析尿 NGAL/尿肌酐（Cr）及尿 KIM-1/尿Cr与ACR/尿Cr之间的相关关系.结果 （1）NA组、MI组、MA组的GLU水平均高于对照组,差异有统计学意义（P均＜0.05）.MA组的肾小球滤过率（GFR）较其他3组降低,差异有统计学意义（P均＜0.05）.MA组的血肌酐（SCr）水平较其他3组升高,差异有统计学意义（P均＜0.05）.MI组和MA组的尿NGAL/尿Cr、尿KIM-1/尿Cr均较对照组和NA组升高,差异均有统计学意义（P均＜0.05）.（2）糖尿病患者尿NGAL/尿Cr与ACR/尿Cr呈正相关性（r=0.864,P＜0.001）,尿KIM-1/尿Cr与ACR/尿Cr亦呈正相关性（r=0.835,P＜0.001）.结论 NGAL、KIM-1可能参与了DN的发生与发展,尿NGAL、KIM-1有望成为判断DN肾损害程度的指标之一.

英文摘要：

Objective To explore the changes of urinary NGAL and KIM - 1 in patients with diabetic nephropathy and their clinical significance. Methods 70 patients with type 2 diabetes mellitus （T2DM） admitted to our hospital were divided in- to normal albuminuria group （NA group, 28 cases）, micro albuminuria group （MI group, 22 cases） and macro albuminuria group （MA group, 20 cases） according to albumin- to- creatinine ratio （ACR） . Meanwhile, 23 non- diabetic and non- ne- phropathy patients were involved as control group. The levels of NGAL and KIM - 1 of the four groups were detected by ELISA and were then analyzed. The correlation of urine NGAL/urine Cr, urine KIM - 1/urine Cr and ACR/urine Cr was also ana- lyzed. Results （ 1 ） The blood glucose levels of NA group, MI group and MA group were all significantly higher than that of the control group （ P all 〈 0.05 ） . The GFR level of the MA group was significantly lower than the other three groups （ P all 〈 O. 05）. The SCr level of the MA group was significantly higher than the other three groups （P all 〈 0. 05） . The urine NGAL/u- rine Cr and urine KIM - l/urine Cr in MI group and MA group were significantly higher than the control group and NA group （ P all 〈0. 05 ） . （2） The urine NGAL/urine Cr were positively correlated with ACR/urine Cr （r = 0. 864, P 〈 0. 001 ）, and the urine KIM - 1/urine Cr were also positively correlated with ACR/urine Cr （ r = 0. 835, P 〈 0. 001 ） . Conclusion NGAL and KIM - 1 may play an important role in the occurrence and development of DN, and urine NGAL and KIM - 1 might be predictors of the severity of DN.