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[摘要] 目的 探究高血压和糖尿病早期肾脏损伤患者行尿微量白蛋白检测的效果和意义。方法 方便择取2017年11月—2018年12月期间该院收治的50例高血压和糖尿病肾脏早期损伤患者设置为观察组，另择取同期在该院进行常规体检的健康者共50名为对照组，两组受检者均行尿微量白蛋白水平检测，对两组受检者尿微量白蛋白水平、不同病程患者間的尿微量白蛋白水平、不同高血压分级患者尿微量白蛋白水平进行比较。 结果 观察组患者尿微量白蛋白水平（65.43±3.58）mg/L相比对照组（13.28±2.26）mg/L显著更高，数据差异有统计学意义（t=87.100 7，P<0.05）;病程超过15年患者尿微量白蛋白水平（116.32±6.75）mg/L相比病程不足15年患者（52.27±3.42）mg/L和（88.75±4.38）mg/L显著更高，数据差异有统计学意义（t=30.294 4、26.115 4、14.977 2，P<0.05）;观察组内高血压Ⅰ级患者尿微量白蛋白水平（60.13±2.75）mg/L、Ⅱ级（92.84±6.85）mg/L和Ⅲ级（121.39±9.46）mg/L差异有统计学意义（t=18.629 4、13.415 1、7.653 4，P<0.05），其中Ⅲ级患者尿微量白蛋白水平最高。 结论 随着患者病情的发展以及病程的延长，IQ尿微量白蛋白水平则会有明显上升趋势，这说明患者肾功能损伤愈发严重，由此可见针对高血压、糖尿病患者检测其尿微量白蛋白水平能够及时发现患者肾脏损伤情况和程度，有利于为患者后期临床治疗提供有效依据，该方法可用于临床推广。

[关键词] 尿微量白蛋白;肾脏早期损伤;糖尿病;高血压

[中图分类号] R5          [文献标识码] A          [文章编号] 1674-0742（2019）08（c）-0185-04

[Abstract] Objective To investigate the effect and significance of urinary microalbumin in patients with hypertension and early diabetic kidney injury. Methods Convenient selected fifty patients with hypertension and diabetic early kidney injury admitted to our hospital from November 2017 to December 2018 were enrolled in the observation group. Another 50 healthy subjects who underwent routine physical examination in our hospital during the same period were selected in the control group， the urine microalbumin levels were measured in both groups. The urine microalbumin levels in the two groups， the urine microalbumin levels in patients with different disease durations， and the urine microalbumin levels in patients with different hypertension grades were ompared. Results The urinary albumin level （65.43±3.58） mg/L in the observation group was significantly higher than that in the control group （13.28±2.26） mg/L. The difference was statistically significant （t=87.100 7， P<0.05）. Urinary microalbumin levels （116.32±6.75） mg/L in patients with a disease duration of more than 15 years were significantly higher than those with a disease duration of less than 15 years （52.27±3.42） mg/L and （88.75±4.38） mg/L. Academic significance （t=30.294 4， 26.115 4， 14.977 2， P<0.05）; urinary microalbumin levels （60.13±2.75） mg/L， grade II （92.84±6.85） mg/L and III in patients with hypertension in class I were observed （121.39±9.46） mg/L was statistically significant （t=18.629 4， 13.415 1， 7.653 4， P<0.05）， and the level of urinary albumin was the highest in grade III patients. Conclusion With the development of the patient's condition and the prolongation of the disease course， the level of IQ microalbumin will increase significantly， which indicates that the patient's renal function damage is more serious. It can be seen that the urine micro-white is detected for patients with hypertension and diabetes. The protein level can timely detect the condition and extent of renal injury in patients， which is beneficial to provide effective evidence for the later clinical treatment of patients. This method can be used for clinical promotion.

[Key words] Urinary microalbumin; Early kidney injury; Diabetes; Hypertension

糖尿病和高血压均为临床常见慢性疾病，长时间血糖血压升高均会对患者的肾脏功能造成一定损伤，严重者可导致患者肾脏功能衰竭进而死亡。由糖尿病和高血壓引发的肾损伤早期无明显临床症状，因此常规检查无法及时发现患者肾脏受损程度等问题，这对患者的健康及生活质量均造成了一定的负面影响[1]。现阶段临床中针对肾脏早期损伤的诊断多采取实验室指标检查，例如血清胱抑素、尿视黄醇结合蛋白以及β2微球蛋白等。由于白蛋白分子量较大，因此在正常条件下其无法通过肾小球基底膜，所以健康者的尿液样本中白蛋白含量偏低且具有良好的稳定性。而糖尿病以及高血压至早期肾损伤患者尿液标本中微量白蛋白排泄量有所增加，导致其肾小球滤过率也有明显的提升，在此阶段对患者进行尿微量白蛋白水平进行检测，能够在患者未发生肾组织学结构异常改变前发现患者肾脏损伤情况，对患者的治疗和预后改善具有积极意义[2]。……