乳胶凝集比浊法和速率散射比浊法检测超敏CRP在糖尿病肾病中的辅助诊断价值分析  

Diagnostic value of hs-CRP in diabetic nephropathy detected by emulsion agglutination turbidimetric assay and speed scattering turbidimetric assay

作　　者：李齐光[1] 梁雅茹 钟辉州 

机构地区：[1]中山大学附属第三医院检验科,广州510630 [2]中山大学附属第一医院检验科,广州510080

出　　处：《新医学》2016年第11期770-774,共5页Journal of New Medicine

摘　　要：目的探讨乳胶凝集比浊法(乳胶法)和速率散射比浊法(速率法)检测超敏CRP(hs-CRP)对糖尿病肾病(DN)的辅助诊断价值。方法收集单纯糖尿病患者28例(单纯糖尿病组)、DN患者38例(DN组)和30名健康人(健康对照组)的外周血标本,分别采用乳胶法和速率法检测3组血液标本的hs-CRP水平,应用受试者工作特征(ROC)曲线评价2种方法对hs-CRP在DN患者的辅助诊断效能;同时使用胶乳增强免疫透射比浊法检测3组的血清胱抑素C水平,应用ROC曲线评价hs-CRP和胱抑素C联合检测对DN患者的辅助诊断效能。结果乳胶法和速率法均显示,DN组、单纯糖尿病组血hs-CRP水平、hs-CRP阳性率均高于健康对照组(P均<0.05),且DN组血hs-CRP水平、hs-CRP阳性率均高于单纯糖尿病组(P均<0.05)。ROC曲线显示,乳胶法检测hsCRP的诊断敏感度(82%)和特异度(89%)均较高;而速率法敏感度较低(79%)、特异度较高(90%);hs-CRP和胱抑素C联合诊断的敏感度为87%、特异度为92%,均高于hs-CRP单一指标。结论 hs-CRP的检测对DN的诊断有重要临床意义,乳胶法检测hs-CRP对DN的诊断效能优于速率法,hs-CRP和胱抑素C联合检测有助于提高对DN诊断的敏感度和特异度。Objective To evaluate the value of high-sensitivity C-reactive protein （ hs-CRP） in the diagnosis of diabetic nephropathy （ DN） detected by the emulsion agglutination turbidimetric assay and speed scattering turbidimetric assay. Methods Peripheral blood sampling was collected from patients with diabetes mellitus alone （ DM group, n = 28 ） , DN patients （ DN group, n = 38 ） and healthy counterparts （ control group, n =30）. Serum concentration of hs-CRP among three groups was detected by emulsion agglutination tur-bidimetric assay and speed scattering turbidimetric assay. The application value of hs-CRP level detected by two assays in the diagnosis of DN was evaluated by the receiver operating characteristic （ ROC ） curve. Cystatin C （ CysC） level was detected by the latex enhanced immunoturbidimetry method among three groups, and the application value of the combined detection of hs-CRP and CysC in the diagnosis of DN was evaluated by the ROC. Results Both two assays revealed that the serum level of hs-CRP and positive rate of hs-CRP in the DM and DN groups were significantly higher than those in the healthy control group （ all P 〈 0. 05 ） , and the serum level of hs-CRP and positive rate of hs-CRP in the DN group were considerably higher than those in the DM group （ both P 〈 0. 05 ）. The ROC curve analysis demonstrated that the sensitivity and specificity of the emul-sion agglutination turbidimetric assay were 82% and 89%,and 79% and 90% for the speed scattering turbidi-metric assay. The sensitivity and specificity of the combination of hs-CRP and CysC were 87% and 92% , high-er compared with those of hs-CRP alone. Conclusions Serum level of hs-CRP is of clinical significance for the diagnosis of DN. The emulsion agglutination turbidimetric assay is superior to the speed scattering turbidi-metric assay in the diagnostic performance of DN. Combined detection of hs-CRP and CysC contributes to improving the sensitivity and specificity in the diagnosis of DN

关 键 词：超敏C反应蛋白 胱抑素C 糖尿病肾病 受试者工作特征曲线 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学] R446.1[医药卫生—临床医学]