2型糖尿病肾病患者尿Ⅳ型胶原和层粘连蛋白测定的临床意义  

Clinical significance of urinary type Ⅳ collagen and laminin determination

作　　者：田小平[1] 徐宁[2] 郑萍[1] 尹冬[2] 苏彩女[1] 庄惠芹[1] 

机构地区：[1]连云港市第一人民医院检验科,连云港市222002 [2]连云港市第一人民医院内分泌科,连云港市222002

出　　处：《中国糖尿病杂志》2010年第12期910-912,共3页Chinese Journal of Diabetes

基　　金：连云港市卫生局科研项目(ZC208)

摘　　要：目的应用受试者工作特征曲线(ROC)评价尿Ⅳ型胶原和尿层粘连蛋白(LN)在糖尿病肾病(DN)监测中的临床价值。方法 143例病程大于5年的T2DM患者和103名正常对照用放射免疫法测定晨尿Ⅳ型胶原和尿LN水平,分析正常白蛋白尿的T2DM患者尿Ⅳ型胶原和尿LN的变化和ROC曲线下面积等。结果正常尿白蛋白组和微量尿白蛋白组的T2DM患者晨尿Ⅳ型胶原和尿LN水平均显著高于正常对照组(P<0.05);尿Ⅳ型胶原>18.9 ng/mL和尿LN>130.33 ng/mL为正常参考范围上限;正常尿白蛋白的T2DM患者以晨尿Alb=16 mg/L为分界值时,尿Ⅳ型胶原曲线下面积(0.749)超过Alb/Cr面积(0.698)、尿Ⅳ型胶原和尿LN水平有显著变化(P<0.05)。结论病程大于5年的正常尿白蛋白T2DM患者晨尿Ⅳ型胶原>18.9 ng/ml或和尿LN>130.33 ng/ml时,应高度怀疑早期DN。Objective To evaluate the role of urinary type Ⅳ collagen and urinary laminin LN（LN） in screening diabetic nephropathy. Methods The urinary levels of Ⅳ and LN were measured by radioimmunoassay （RIA） in 143 cases with type 2 diabetes mellitus （T2DM） with the course over 5 years and in 103 normal controls （NC）. The sensitivity and specificity of urinary IV and LN, UAlb/cre and urinary creatinine for diabetic nephropathy diagnosis were calculated and ROC curve was drawed. The area under curve of ROC of urinary Ⅳ and LN was compared with that of Alb/Cr in normal urinary albumin group of T2DM. Results The levels of Ⅳ and LN in group A（Alb/Cr〈30mg/g） and group B（Alb/Cr 30- 300 mg/g） were significantly higher than those in NC（P〈0.05）. The upper limit for the nomal referance of IV and LN were 18.9 ng/mL and 130.33 ng/mL respectively. In A group,AUCⅣ, （0. 749） was larger than AUCAlb/cr（0. 698） when Alb of 16 mg/L was a cut point. Conclusions The level of urinary IV and LN is a useful marker in screening DN. The urinaryⅣ〉18.9 ng/ml and/or LN〉130.2,3 ng/mL in T2DM course beyond 5 years may be an indicator for DN.

关 键 词：尿Ⅳ型胶原 尿层粘连蛋白 糖尿病肾病 ROC曲线 

分 类 号：R587.2[医药卫生—内分泌]