目的 探讨呼出气体中丙酮能否用于糖尿病肾病的早期诊断。方法 对健康对照组、2型糖尿病组(T2MD)和糖尿病肾病组(DN)分别采用气相色谱-质谱(GC-MS)法测定呼气丙酮含量、全自动生化仪的乳胶透射免疫比浊法测定尿微量白蛋白、酶速率法测试β-羟丁酸以及全自动尿液分析仪干化学法测定尿酮体,并对上述结果进行分析。结果 在T2MD组和DN组中呼气中的丙酮含量均高于健康对照组(P<0.01);在DN组,丙酮与尿微量白蛋白水平呈线性相关(r=0.79,P<0.05)。结论 检测呼气中的丙酮有助于糖尿病肾病的早期诊断,能及时反映病人肾脏损伤情况。

Objective To explore the early diagnosis of diabetic nephropathy by exhaled acetone. Methods Respectively using GC-MS method for the determination of exhaled acetone content, emulsion transmission turbidimetric immunoassay method in automatic biochemical analyzer for determination of urinary microalbumin, enzyme rate method for testing β-hydroxybutyric acidand and dry chemical method in urine automatic analyzer for determination of urine ketone on healthy control group, type-2 diabetes mellitus group(T2MD), and diabetic nephropathy group(DN), and the above results were analyzed. Results The exhale acetone level in T2MD and DN groups were higher than those in control group(P<0.01); In DN group, the level of exhale acetone with urinary microalbumin had a linear correlation. Conclusion The detection of exhale acetone is helpful to early diagnosis in diabetic nephropathy, also may reflect the renal injury promptly.