血清和尿液多指标联合检测在糖尿病早期肾损伤诊断中的价值  

Value of combined detection of serum and urine indexes in diagnosis of early diabetic nephropathy

作　　者：雷明[1] 张毅 LEI Ming;ZHANG Yi(Department of nephrology , The third people＇s hospital of Yibin , Yibin 644000, Chin)

机构地区：[1]宜宾市第三人民医院肾内科,四川宜宾644000

出　　处：《吉林医学》2018年第5期840-842,共3页Jilin Medical Journal

摘　　要：目的:探讨血液指标(血清胱抑素C、β_2-微球蛋白和C-反应蛋白)和尿蛋白指标(微量尿白蛋白、尿转铁蛋白和尿视黄醇结合蛋白)单一或联合检测对糖尿病肾病的早期诊断价值。方法:随机选取2型糖尿病患者160例,按尿白蛋白排泄量/肌酐比值(UACR)分为正常蛋白尿组(64例)、微量蛋白尿组(51例)和大量蛋白尿组(45例),并选取50例健康成年人为对照组,比较各组上述6指标的差异,并分析单一诊断和联合诊断时糖尿病肾病的检出情况。结果:4组对象血清胱抑素C、β_2-微球蛋白、C-反应蛋白、微量尿白蛋白、尿转铁蛋白和尿视黄醇结合蛋白差异均有统计学意义(P<0.01),微量蛋白尿组和大量蛋白尿组血液3指标联合诊断阳性率可达82.4%和91.1%,尿液3指标联合诊断阳性率分别达80.4%和86.7%,将Cys C、β_2-MG、MA和TRF4指标联合诊断,微量蛋白尿组和大量蛋白尿组阳性检出率分别达88.2%和93.3%。结论:血液指标血清胱抑素C、β_2-微球蛋白、C-反应蛋白和尿液指标微量尿白蛋白、尿转铁蛋白、尿视黄醇结合蛋白对糖尿病肾病早期诊断有重要价值,多指标联合诊断能提高灵敏度。Objective To discuss the value of alone/combined detection of serum Cystatin C（Cys C）,β2-microglobulin（β2-MG）,C reactive protein（CRP） and urine microalbumin（MA）,transferrin（TRF） and retinol binding protein（RBP） in Diagnosis of early diabetic nephropathy. Method 160 type 2 diabetes patients were selected from our hospital randomly and divided into 3 groups（normal proteinuria,microalbuminuria and massive proteinuria group） according to urinary albumin creatinine ratio（UACR）,then 50 healthy people were selected as control,finally the difference of above 6 indexes among 4 groups and detection of diabetic nephropathy in alone/combined diagnosis were observed. Results The differences of Cys C,β2-MG,CRP,MA,TRF and RBP among 4 groups were significant（P〈0. 01）. The diagnostic positive rate according to combined 3 serum indexes were 82. 4% and 91. 1% respectively in microalbuminuria and massive proteinuria group and positive rate according to 3 urine indexes were 80. 4% and 86. 7% respectively. According to 4 indexes（Cys C、β2-MG、MA and TRF）,the positive rate were 88. 2% and 93. 3% respectively in microalbuminuria and massive proteinuria group. Conclusion Serum indexes including Cys C,β2-MG,CRP and urine indexes including MA,TRF,RBP has important diagnosis value for early diabetic nephropathy（DN）. Multi-indexes combined detection can improve sensitivity for DN diagnosis.

关 键 词：糖尿病肾病 血清胱抑素C 血清Β2-微球蛋白 尿微量白蛋白 尿转铁蛋白 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]