目的：探讨尿中性粒细胞明胶酶相关脂质运载蛋白（neutrophil gelatinase-associated lipocalin,NGAL）/肌酐比值在2型糖尿病患者肾脏损伤的早期诊断及病情评估中的临床应用价值。方法：纳入2型糖尿病患者112例，根据尿白蛋白/肌酐比值（urinary albumin/creatinine ratio，UACR）将患者分为尿白蛋白正常（normo-albuminuria, NA）组（38例）、微量白蛋白尿（micro-albuminuria, MA）组（36例）及临床白蛋白尿（clinical albuminuria, CA）组（38例），并以同期32例健康体检者作为正常对照。采用化学发光微粒子免疫检测法测定各组的尿NGAL浓度，并计算尿NGAL/肌酐比值。比较正常对照组及2型糖尿病各组的尿NGAL水平，并与其他临床指标作相关性分析。结果：2型糖尿病各组的尿NGAL/肌酐比值均明显高于正常对照组[正常对照组，9.13(3.92~17.36) ng/mg;NA组，16.46(6.94~27.07) ng/mg;MA组，20.16(6.76~44.35) ng/mg;CA组，26.89(10.60~56.94) ng/mg]（P<0.05），而在2型糖尿病各组间，CA组、MA组的NGAL/肌酐比值明显高于NA组（P<0.05）。相关性分析显示，尿NGAL/肌酐比值与UACR、糖尿病病程、糖化血红蛋白（glycated hemoglobin, HbA1c）呈正相关（P<0.05）。结论：与尿微量白蛋白相比，尿NGAL/肌酐比值可能较更早提示2型糖尿病患者的肾脏损伤，并可在一定程度上评估其疾病严重程度。

Objective: To investigate the application of urinary neutrophil gelatinase associated lipocalin (NGAL)/creatinineratio in the early diagnosis and assessment of severity of renal injury in patients with type 2 diabetes mellitus (T2DM). Methods: A group of 112 T2DM patients were recruited. Based on urinary albumin/creatinine ratio (UACR), diabetic patients were divided into three groups: 38 cases with normal albuminuria (NA group), 36 cases with minimal albuminuria (MA group) and 38 cases with clinical albuminuria (CA group). And, 32 healthy subjects were served as controls (NC group). Urinary NGAL/creatinine ratio was calculated and compared among the groups and their correlations with other clinical parameters were analyzed. Results: Urinary NGAL/creatinine ratio in T2DM groups [NA, 16.46(6.94-27.07) ng/mg;MA, 20.16(6.76-44.35) ng/mg;CA, 26.89(10.60-56.94) ng/mg] was markedly increased than that in the normal control group [9.13(3.92-17.36) ng/mg] (P<0.05). In the T2DM groups, urinary NGAL/creatinine ratio in CA group was significantly higher than that in NA group (P<0.05). Correlation analysis showed that urinary NGAL/creatinine ratio was positively correlated with UACR, duration of diabetes and glycated hemoglobin (HbA1c) (P<0.05). Conclusions: Urinary NGAL could be an earlier marker than minimal albuminuria for detecting renal injury in T2DM. Furthermore, urinary NGAL level can evaluate the severity of renal injury.