血清NGAL、Cys C和尿NAG联合检测在糖尿病肾病诊断中的临床意义  

Clinical significance on serum NGAL,Cys C and urinary NAG combined determination in the diagnosis of diabetic nephropathy

作　　者：王依屹[1] 张珏[1] 鲁传翠[1] 罗云桃[1] 

机构地区：[1]上海中医药大学附属曙光医院检验科,上海201203

出　　处：《检验医学》2015年第11期1096-1099,共4页Laboratory Medicine

摘　　要：目的探讨血清中性粒细胞明胶酶相关载脂蛋白（NGAL）、半胱氨酸蛋白酶抑制剂C（CysC）和尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）检测在糖尿病肾病（DN）诊断中的临床意义。方法选取2型糖球病患者（T2DM）76例，根据其尿液白蛋白排泄率（UAER）分成3组：正常白蛋白尿组（26例，UAER〈30mg／24h）、微量白蛋白尿组（25例，UAER为30～300mg／24h）、临床蛋白尿组（25例，UAER〉300mg／24h）；选择同期正常体检者40名作为正常对照组。检测所有对象的血清NGAL、CysC和尿NAG，分析检测结果与肾小球滤过率（GFR）的关系，采用受试者工作特征（ROC）曲线下面积评价3个指标对DN的诊断效率。结果微量白蛋白尿组和临床蛋白尿组血清NGAL、CysC和尿NAG水平均高于正常对照组（P〈0．05）；T2DM患者血清NGAL、CysC和尿NAG水平与GFR呈负相关[相关系数（r）分别为-0．85523、-0．76014、-0．70117，P均〈0．05]；3项指标中血清NGAL的ROC曲线下面积（0．862）最高，诊断效率最好。结论血清NGAL与GFR关系最为密切，可用于DN的早期诊断和监测。Objective To investigate the clinical significance of serum neutrophil gelatinase-associated lipocalin （NGAL）, cystatin C （Cys C ） and urinary N-acetyl-beta-D-glucosaminidase （NAG） in the diagnosis of diabetic nephropathy （DN）. Methods According to urinary albumin excretion rate （UAER）, 76 type 2 diabetes mcllitus （T2DM） patients were classified into 3 groups, normal albuminuria group（26 cases, UAER 〈 30 rag/24 h）, micro- albuminuria group （ 25 cases, UAER = 30-300 rag/24 h ） and clinical albuminuria group （ 25 cases, UAER 〉 300 rag/24 h）. Another 40 healthy subjects were enrolled as healthy control group. The relationship of NGAL, Cys C and urinary NAG with glomerular filtration rate （GFR） was analyzed. The area under receiver operating characteristic （ROC） curve was used for the diagnosis efficiency of DN . Results Serum NGAL, Cys C and urinary NAG of micro- albuminuria group and clinical albuminuria group were higher than those of healthy control group （ P 〈 0.05 ）. Serum NGAL , Cys C and urinary NAG were negatively correlated with GFR [ correlation coefficient （ r ） = - 0. 855 23, - 0. 760 14 and - 0. 701 17, P 〈 0.051. The area under ROC curve of serum NGAL （0. 862） was biggest, and the diagnosis efficiency was highest. Conclusions Serum NGAL which has a good correlation with GFR is expected to be used in clinical diagnosis and monitor.

关 键 词：中性粒细胞明胶酶相关载脂蛋白 半胱氨酸蛋白酶抑制剂C N-乙酰-Β-D-氨基葡萄糖苷酶 糖尿病 

分 类 号：R446.1[医药卫生—诊断学]