肾损伤分子-1在糖尿病肾脏早期损伤中的诊断价值研究  

Diagnostic value of kidney injury molecule 1 in the early stage of diabetic nephropathy

作　　者：黄炎[1] 章爽[1] 黄伟[1] 朱建华[1] 张宏玮[1] 胡娜[1] 

机构地区：[1]武汉市第一医院检验科,湖北武汉430022

出　　处：《中国实验诊断学》2017年第8期1299-1302,共4页Chinese Journal of Laboratory Diagnosis

基　　金：国家高技术研究发展计划(863计划)2014AA022304

摘　　要：目的探讨血清、尿Kim-1(Kidney injury molecular 1,Kim-1)检测在糖尿病肾病(diabetic nephropathy,DN)早期诊断及病情发展中的预测价值。方法选取武汉市第一医院内分泌科住院的2型糖尿病患者(type 2diabetes mellitus,T2DM)241例,根据尿清蛋白排泄率(UAER)将DN患者分为三组:正常清蛋白尿组或单纯糖尿病组(NA组);微量清蛋白尿组(MI组);大量清蛋白尿组(MA组);64例健康体检者作为正常对照组(NC组)。通过采用酶联免疫吸附法(ELISA)检测各组血清、尿标本中的Kim-1浓度;乳胶增强免疫比浊法检测U-mALB及血清CysC水平。结果 NA、MI、MA组患者血清、尿Kim-1水平与NC组比较均显著升高,差异有统计学意义(P<0.05),但尿NA组患者Kim-1水平与MI组相比无统计学意义(P>0.05)。NA、MI及MA组患者UAER、U-mALB、血清CysC、FPG、HbAic、BUN、SCr浓度与NC组比较升高,差异均有统计学意义(P<0.01)。结论 T2DM早期肾损伤血清、尿Kim-1水平升高迅速,是临床诊断早期DN敏感而准确的指标,具有较高的临床诊断价值。Objective To investigate the diagnostic and predictive value of measuring of serum and urine Kim-1 in patients with diabetic nephropathy.Methods A total of 241 patients with type 2 diabetes mellitus（T2DM）from Wuhan NO.1 hospital were divided into normal albuminuria group（Group NA）,micro-albuminuria group（Group MI）,macro-albuminuria group（Group MA）according to urine albumin excretion rate.64 health subjects were enrolled as normal control group（Group NC）.The levels of Kim-1 in serum and urine were detected by ELISA.Results The serum and urine level of Kim-1 in group NA,MI,MA was significantly higher than that in group NC（P〈0.05）.However,there was no significant difference of urine Kim-1 between group NA and group MI（P〉0.05）.Compared with NC group,UAER,U-mALB,CysC,FPG,HbAic,BUN,SCr in NA,MI and MA groups were obviously increased（P〈0.01）.Conclusion The levels of Kim-1 in serum and urine were obviously elevated in early renal damage.They can be used as a sensitive indicator of early renal damage in DN,and will have great significance for early diagnosis and surveillance of DN.

关 键 词：肾损伤分子-1 尿白蛋白 血清胱抑素C 糖尿病肾病 

分 类 号：R446.6[医药卫生—诊断学] R587.2[医药卫生—临床医学] R692.9