尿蛋白和尿酶联合检测在糖尿病肾病早期诊断中的应用价值  

The combined detection value of urine protein and urine enzyme in the early diagnosis of diabetic kidney disease

作　　者：茅肖娜 高国生[2] 沈洁琼 李珂 MAO Xiao-na GAO Guo-sheng SHEN Jie-qiong LI Ke(Clinical Laboratory, the Second Hospital of Yinzhou, Ningbo, Zhejiang 315100, China)

机构地区：[1]宁波市鄞州第二医院检验科,浙江宁波315100 [2]宁波市第二医院检验科,浙江宁波315010

出　　处：《中国卫生检验杂志》2017年第18期2636-2638,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨尿微量白蛋白/肌酐(ACR)、尿β_2-微球蛋白(β_2-MG)、尿视黄醇结合蛋白(RBP)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿α1-微球蛋白(α1-MG)及其联合测定在糖尿病肾病(DKD)早期诊断中的应用价值。方法收集83例糖尿病肾病早期患者(DKD组)和70例健康体检者(对照组)的尿液标本,测定所有受试者尿ACR、尿β_2-MG、尿RBP、尿NAG、尿α1-MG水平,并对结果进行统计学分析。结果与对照组比较,DKD组尿ACR、尿β_2-MG、尿RBP、尿NAG、尿α1-MG水平均升高且差异均有统计学意义(P均<0.01)。ROC曲线结果显示,尿ACR的AUC为0.916,尿β_2-MG的AUC为0.779,尿RBP的AUC为0.9,尿NAG的AUC为0.868,尿α1-MG的AUC为0.915;联合检测的AUC为0.989。5个指标联合检测的阳性率和灵敏度均高于各单独指标。结论尿ACR、尿β_2-MG、尿RBP、尿NAG、尿α1-MG的联合检测可以有效提高糖尿病肾病的早期检出率,值得临床推广。Objective To investigate the application value of urine albumin creatinine ratio（ ACR）,urine β2-microglobulin（ β2-MG）,urine retinol binding protein（ RBP）,urine N-acetyl-β-D-glucosaminidasa kit（ NAG） and urine α1-microglobulin（ α1-MG） and their combined detection in the early diagnosis of diabetic kidney disease（ DKD）. Methods Urine samples were collected from 83 patients with diabetic kidney disease（ DKD group） and 70 people undergoing the physical examination（ control group）. Urine ACR,β2-MG,RBP,NAG,α1-MG were detected in all subjects and detection results were analyzed statistically. Results The levels of urine ACR,β2-MG,RBP,NAG and α1-MG in 83 patients with diabetic kidney disease were significantly higher than those in the control group,with the differences statistically significant（ P〈0. 01）.The ROC curve showed that AUC of urine ACR for diagnosing DKD was 0. 916,AUC of urine β2-MG was 0. 779,AUC of urine RBP was 0. 9,AUC of urine NAG was 0. 868,AUC of urine α1-MG was 0. 915,while AUC of the combined detection was 0. 989. The positive rate and sensitivity of 5-index combined detection were higher than those of single detection. Conclusion The combined detection of urine ACR,β2-MG,RBP,NAG,α1-MG has more clinical significance in the early detection of diabetic kidney disease than the single detection,so it is worth promotion.

关 键 词：糖尿病肾病 Β2-微球蛋白 N-乙酰-Β-D-氨基葡萄糖苷酶 视黄醇结合蛋白 Α1-微球蛋白 

分 类 号：R587.24[医药卫生—内分泌]