检测BNP、eGFR在2型糖尿病肾病中的诊断价值  

Diagnostic value of BNP and e GFR detection in patients with diabetic nephropathy type 2

作　　者：余国庆 王欣[2] 韩善林 刘华香[3] 

机构地区：[1]芜湖市海螺医院检验科,安徽芜湖241000 [2]中国人民解放军三0七医院检验科,北京100071 [3]淮南市新华医疗集团北方医院检验科,安徽淮南232082

出　　处：《中国卫生检验杂志》2015年第13期2148-2150,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨B型钠尿肽(BNP)、肾小球滤过率(e GFR)在诊断2型糖尿病肾病病变程度中的价值及临床意义。方法选择2型糖尿病患者137例及健康对照组50例,检测其血浆BNP、血清肌酐(Scr)以及24 h尿白蛋白排泄率(UAER),按照UAER将糖尿病患者分为:正常蛋白尿组(NA组)50例、微量蛋白尿组(MA组)51例、临床蛋白尿组(CP组)36例,并对检测结果进行统计学分析。结果 MA组和CP组BNP水平均显著高于NC组及NA组,糖尿病患者BNP随UAER增加而增加,呈正相关(r=0.724,P<0.01);CP组e GFR显著低于其他3组,差异有统计学意义(P<0.05),e GFR与UAER呈负相关(r=-0.609,P<0.01);ROC曲线分析,BNP曲线下面积为0.782,cut-off值为61.65 pg/ml,灵敏度为67.81%,特异度为70.00%,准确度为68.61%;而e GFR曲线下面积为0.223。结论糖尿病肾病患者血浆BNP水平明显升高,对2型糖尿病肾病的诊断具有一定价值;e GFR随2型糖尿病肾病病情发展而降低,但不适合作为2型糖尿病肾病的早期诊断指标。Objective To explore the value and clinical significance of BNP and eGFR in the diagnosis of diabetic nephropathy type. Methods 137 patients with type 2 diabetes and 50 healthy people were selected for the detection of plasma BNP, Scr and UAER in 24 h. These patients were classified into three groups according to the urine albumin excretion rate （UAER） , including the normal albuminuria group（50）, the micro albuminuria group（51 ） and clinical protein uria group（36）, and the detection results were statistically analyzed. Results The levels of BNP in group MA and group CP were significantly higher than those in the group NC or NA, and the BNP in patients with diabetic nephropathy increased with UAER, which was positively correlated with UAER （r =0. 724, P 〈0.01 ）, and the eGFR in CP group were significantly lower than that in the other 3 groups eGFR, and the difference had statistical significance, and eGFR was negatively correlated with UAER （ r = - 0. 609, P 〈0.01 ） ; with correlation analysis, the area under curve was 0. 782, the cut - off point of BNP was 61.65 pg/ml, base on this, the sensitivity, specificity and accuracy was 67.81%, 70.00% and 68.61%, respectively; while, the area under curve of eGFR was 0.223. Conclusion The plasma levels of BNP significantly increased in type 2 diabetic patients, which might to be valuable in the diagnosis of type 2 diabetic nephropathy; eGFR decreased with nephropathy progression, but not suitable as indicators of the diabetic nephropathy in the early diagnosis.

关 键 词：B型钠尿肽 肾小球滤过率 糖尿病肾病 

分 类 号：R587.1[医药卫生—内分泌]