2型糖尿病肾病患者血清血管紧张素转换酶活性检测及其意义  

Clinical significance of serum angiotensin converting enzyme activity detection in type 2 diabetic nephropathy patients

作　　者：杨雅芸[1] 高国生[1] 

机构地区：[1]宁波市第二医院检验科,浙江宁波315000

出　　处：《中国卫生检验杂志》2016年第12期1717-1719,共3页Chinese Journal of Health Laboratory Technology

基　　金：宁波市领军和拔尖人才(20150012)

摘　　要：目的探讨2型糖尿病肾病患者血清血管紧张素转换酶（ACE）检测的临床意义。方法选择2型糖尿病患者（DM）301例和健康体检者291例,根据尿微量白蛋白/肌酐比值（UACR）将DM患者分为正常白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组,分析血清ACE、肾功能指标,绘制ROC曲线分析血清ACE对微量和大量白蛋白尿的诊断价值,并对大量白蛋白尿发生的危险因素进行多因素Logistic回归分析。结果 2型糖尿病患者血清ACE活性显著高于正常对照组,差异有统计学意义（t=-6.703,P〈0.01）。无白蛋白尿组与微量白蛋白尿组之间ACE活性差异无统计学意义（P〉0.05）,而大量白蛋白尿组显著高于其他组,差异有统计学意义（P〈0.05）。血清ACE诊断微量白蛋白尿和大量白蛋白尿的AUC分别为0.649（0.595-0.707）和0.680（0.608-0.750）,P〈0.001,后者优于前者。多因素Logistic回归分析,结果显示血清ACE和Cr为糖尿病患者发生大量白蛋白尿的独立危险因素。结论血清ACE活性与2型糖尿病肾病有比较密切的关系,血清ACE高活性可能是肾病发展到后期的危险标志。Objective To investigate the clinical significance of serum angiotensin- converting enzyme（ ACE） detection in type2 diabetic nephropathy patients. Methods 301 cases of type 2 diabetes mellitus（ DM） patients and 291 cases of healthy people were enrolled in the study. According to urinary albumin / creatinine ratio（ UACR）,DM patients were divided into normal albuminuria group,microalbuminuria group and macroalbuminuria group. The differences of serum ACE and renal function markers among the groups were analyzed. ROC curve was applied to analyze the diagnostic value of serum ACE for microalbuminuria and macroalbuminuria,and multivariate logistic regression analysis was conducted on the risk factors of macroalbuminuria. Results Serum ACE activity in type 2 diabetic patients was significantly higher than the control group,with the difference statistically significant（ t =- 6. 703,P〈0. 01）. The difference of serum ACE activity between non- albuminuria group and microalbuminuria group had no statistical significance（ P〉0. 05）,but macroalbuminuria group was significantly higher than other groups,with the difference statistically significant（ P〈0. 05）. The area under the ROC curve（ AUC） of serum ACE for microalbuminuria and macroalbuminuria was 0. 649（ 0. 595- 0. 707） and 0. 680（ 0. 608- 0. 750）,and the latter was bigger than the former（ P〈0. 001）. Multivariate logistic regression analysis showed that serum ACE was one of the independent risk factors for macroalbuminuria in diabetes patients. Conclusion The serum ACE activity and type 2 diabetic nephropathy have a relatively close relationship,and high serum ACE activity may be a risk marker for the late stage of kidney disease.

关 键 词：血管紧张素转换酶 2型糖尿病 糖尿病肾病 

分 类 号：R587.2[医药卫生—内分泌]