目的　研究肾小球高滤过（GHF）对于早期1型糖尿病肾脏病的筛查价值。方法　入选100例1型糖尿病患儿， 用Macisaac’ s公式估算其肾小球滤过率（eGFR），并按照eGFR水平将患儿分为高滤过组43例，正常滤过率组57例，比较 两组患儿的临床资料。结果　高滤过组糖化血红蛋白（HbA1c）及三酰甘油（TG）水平高于正常滤过率组，而血中性粒细 胞明胶酶相关载脂蛋白（NAGL）水平低于正常滤过率组，差异均有统计学意义（P<0.05）；高滤过组和正常滤过率组的尿 微量白蛋白/肌酐比值（UACR）、尿N-乙酰-β-D-氨基葡萄糖苷酶/肌酐比值（NAG/Cr）、尿α1微球蛋白/肌酐比值（α1-MG/ Cr）的差异则均无统计学意义（P>0.05）。Logistic回归分析显示，病程短、HbA1c高为GHF的危险因素。结论　GHF可反 映1型糖尿病患儿血糖、血脂的紊乱情况，其与糖尿病患儿肾脏损伤的相关性需进一步研究。

Objective　To investigate the screening value of glomerular hyperfiltration (GHF) in early renal damage of type 1 diabetes. Methods　The estimated glomerular filtration (eGFR) was calculated using the Macisaac’s equation in 100 cases of type 1 diabetes. According to eGFR’s level, the diabetes were divide into two groups: Normo-GFR group, 57 cases; and GHF group , 43 cases. The age, course of disease, glycosylated hemoglobin (HbA1c)、triglyceride (TG), renal glomerular damage indexes (UACR), and renal tubular damage indexes (urinary NAG/Cr, urinary α1-MG/Cr and serum NGAL) of each group were observed. Results　The HbA1c and TG values in the GHF group was significantly higher than those in the Normo-GFR group(P＜0.05). Serum NGAL values in the GHF group was significantly lower than those in the Normo-GFR group (P＞0.05). The UACR, urine NAG/Cr and urine α1-MG/Cr values between the GHF group and Normo-GFR group were not significantly different. Logistic regression analysis showed shorter diabetes duration and higher HbA1c levels were important influence factors of whether diabetes patients had hyperfiltration. Conclusions　GHF may reflect abnormal glucose and lipid metabolism that could be detected at early stage of the type 1 diabetes, but its independent correlation with diabetic kidney damage needs further research.