Hcy、hsCRP、Lpa、尿NAG对糖尿病肾病早期诊断的临床意义  

Clinical significance of serum Hcy,hsCRP,Lpa and urine NAG in the diagnosis of early diabetic nephropathy

作　　者：柴凌雄[1] 罗群[1] 周芳芳[1] 董虹[2] 

机构地区：[1]宁波市第二医院肾内科,浙江宁波315010 [2]宁波市第二医院检验科,浙江宁波315010

出　　处：《中国现代医生》2012年第34期42-43,46,共3页China Modern Doctor

基　　金：浙江省医药卫生科技基金项目(2012KYB175);浙江省宁波市自然科学基金项目(2011A610032)

摘　　要：目的探讨血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hsCRP)、脂蛋白a(Lpa)、尿N-乙酰-β-D氨基葡萄糖苷酶(uNAG)对糖尿病肾病(DN)诊断的临床意义。方法根据24 h白蛋白排泄率(UAER),将194名糖尿病患者和60名正常体检者分为糖尿病正常蛋白尿组(DM)、早期糖尿病肾病组(DN1)、临床糖尿病肾病组(DN2)和正常对照组,检测四组患者Hcy、Lpa、hsCRP、uNAG水平。结果随着病情进展,Hcy、hsCRP、Lpa、uNAG水平逐渐升高,糖尿病各组间比较有显著性差异;Hcy、hsCRP、Lpa、uNAG分别与UAER呈正相关(r=0.606,0.676,0.612,0.842;P<0.05);Hcy、hsCRP、Lpa、uNAG的AUC曲线下面积(AUCROC)分别为0.691、0.734、0.707、0.909,以上四项联合检测AU-CROC为0.962,比单个检测准确性更高。结论 Hcy、Lpa、hsCRP、uNAG能作为早期DN诊断的指标。Objective To investigate the clinical significance of serum homocysteine （Hcy）, high sensitivity C-reactive pro- tein （hsCRP）, lipoproterin a （Lpa）, urine N-acetyl-D-glucosaminidase （uNAG） in the diagnosis of diabetic nephropathy. Methods According to 24 hours albumin excretion rate （UAER）, 194 patients with diabetic mellitus and 60 normal subjects were divided into four groups, including diabetes mellitus without albuminuria （DM）, early diabetic nephropathy （DN1）, clinical diabetic nephropathy （DN2） and normal subjects. Serum Hey, Lpa, hsCRP and uNAG of all subjects were measured. Results The levels of Hcy, hsCRP, Lpa and uNAG in every group of DM increased along with the aggravation of the dis- ease, and were significant difference; Hey, hsCRP, Lpa and uNAG was significantly correlated with UAER respectively （r = 0.606, 0.676, 0.612, 0.842; P 〈 0.05）; The area under the receive-operator characteristic curve （AUCROC） of Hey, hsCRP, Lpa, uNAG were 0.691, 0.734, 0.707, 0.909. The combined detection of them was more powerful （AUCROC 0.962） for diag- nosis of diabetic nephropathy, superior to that for single detection. Conclusion Hcy, Lpa, hsCRP, uNAG could be used to as sensitive indicator for the diagnosis of early diabetic nephropathy.

关 键 词：同型半胱氨酸 超敏C反应蛋白 脂蛋白A 尿N-乙酰-Β-D氨基葡萄糖苷酶 糖尿病肾病 

分 类 号：R587.2[医药卫生—内分泌]