5项指标联合检测对早期糖尿病肾病的诊断价值  

Clinical value of 5 indicators combined detection in the diagnosis of early diabetic nephropathy

作　　者：罗丹[1] LUO Dan(Department of Clinical Laboratory,Center Hospital of Longgang,Shenzhen,Guangdong 518116,China)

机构地区：[1]广东省深圳市龙岗中心医院检验科

出　　处：《检验医学与临床》2019年第19期2811-2813,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨血清视黄醇结合蛋白(RBP)、胱抑素C(Cys-C)、可溶性细胞间黏附因子-1(sICAM-1)、尿微量清蛋白(MALB)、β2-微球蛋白(β2-MG)联合检测对早期糖尿病肾病的诊断价值。方法依据尿蛋白定性试验结果将该院137例2型糖尿病患者分为尿蛋白阳性组(n=53)和尿蛋白阴性组(n=84)。另在该院体检中心选取40例健康体检者纳入健康对照组。分别对各组RBP、Cys-C、sICAM-1、MALB、β2-MG水平进行比较,并统计分析单项和联合检测的阳性率。采用受试者工作特征(ROC)曲线比较各指标单项检测和联合检测的诊断效能,并计算各指标的灵敏度、特异度、阳性预测值。结果尿蛋白阴性组、尿蛋白阳性组的RBP、Cys-C、sICAM-1、MALB、β2-MG水平明显高于健康对照组,差异均有统计学意义(P<0.05);尿蛋白阳性组的RBP、Cys-C、sICAM-1、MALB、β2-MG水平明显高于尿蛋白阴性组,差异均有统计学意义(P<0.05)。尿蛋白阳性组患者5项指标联合检测的阳性率明显高于单项检测,差异均有统计学意义(P<0.05)。联合检测的ROC曲线下面积(AUC)达0.865,明显高于各单项指标的AUC。联合检测的灵敏度为90.00%,特异度为92.50%,阳性预测值为93.85%。结论RBP、Cys-C、sICAM-1、MALB、β2-MG水平可反映糖尿病肾病早期肾损伤,5项指标联合检测有助于提高早期糖尿病肾病的检出率,以便尽早采取科学合理的预防和治疗方案。Objective To investigate the clinical value of combined detection of plasma retinol binding protein(RBP),cystatin C(Cys-C),soluble intercellular adhesion factor-1(sICAM-1),microalbumin(MALB),β2-microglobulin(β2-MG)in the diagnosis of early diabetic nephropathy.Methods According to the urine protein qualitative test results,137 patients were divided into urine protein positive group(n=53)and urine protein negative group(n=84).Another 40 healthy subjects were selected into the normal control group from our physical examination center.The levels of RBP,Cys-C,sICAM-1,MALB andβ2-MG were detected and compared,and the positive rates of single and combined detection were statistically analyzed.The receiver operating characteristic(ROC)curve was used to compare the combination of indicators and the diagnostic efficacy of each indicator when used alone,and to calculate the sensitivity,specificity,and positive predictive value of each indicator.Results The levels of RBP,Cys-C,sICAM-1,MALB,andβ2-MG in urine protein positive group and urine protein negative group were significantly higher than those in the normal control group(P<0.05).The levels of RBP,Cys-C,sICAM-1,MALB,andβ2-MG in urine protein positive group were significantly higher than those in the urine protein negative group(P<0.05).The positive rate of combined detection of these five indicators in the urine protein positive group was significantly higher than that of each indicator(P<0.05).The AUC value of combined detection reached 0.865,which was significantly higher than the AUC value of each individual index,the sensitivity of the combined test was 90.00%,the specificity was 92.50%,and the positive predictive value was 93.85%.Conclusion The levels of RBP,Cys-C,sICAM-1,MALB andβ2-MG could reflect the early renal injury of diabetic nephropathy.The combined detection of five indicators could improve the positive rate of early diabetic nephropathy,so as to take scientific and reasonable prevention and treatment options as soon as possible.

关 键 词：视黄醇结合蛋白 胱抑素C 可溶性细胞间黏附因子-1 微量清蛋白 Β2-微球蛋白 糖尿病肾病 早期诊断 

分 类 号：R587.1[医药卫生—内分泌]