血清α1-微球蛋白、尿激肽原1联合检测在糖尿病肾病患者诊断中的临床价值  

The clinical value of combined detection of serum α1-MG and urinary KNG1 in the diagnosis of patients with diabetic nephropathy

作　　者：黄静[1] 黄志刚[2] 黄亨建[2] HUANG Jing;HUANG Zhi gang;HUANG Heng jian(Outpatient Department,West China Hospital,Sichuan University,Chengdu 610041,China;Laboratory Medicine Department,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院门诊部,四川成都610041 [2]四川大学华西医院实验医学科,四川成都610041

出　　处：《实用医院临床杂志》2019年第6期12-15,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨血清α1-微球蛋白(α1-MG)、尿激肽原1(KNG1)联合检测在糖尿病肾病(DN)患者诊断中的临床价值。方法220例糖尿病(DM)患者,根据Mogensen分期标准分为单纯DM组(72例)、早期DN组(68例)及临床期DN组(80例),并纳入同期30例体检健康者作为对照组。比较各组间血清α1-MG、尿KNG1水平,绘制血清α1-MG、尿KNG1单独及联合诊断DN的ROC曲线,比较血清α1-MG、尿KNG1单独及联合诊断DN的效能。结果(1)单纯DM组、早期DN组及临床期DN组α1-MG、KNG1均高于对照组(P<0.05),早期DN组α1-MG、KNG1高于单纯DM组,临床期DN组α1-MG、KNG1高于早期DN组(P<0.05);(2)血清α1-MG诊断AUC低于尿KNG1和联合诊断AUC,尿KNG1诊断AUC低于联合诊断AUC(P<0.05);(3)尿KNG1灵敏度、特异度、准确率、阳性阴性预测值高于血清α1-MG,联合检测灵敏度、特异度、准确率、阳性阴性预测值高于血清α1-MG、尿KNG1单独检测。结论血清α1-MG和尿KNG1联合诊断DN效能良好,有一定临床应用价值。Objective To investigate the clinical value of combined detection of serum α1-microglobulin(α1-MG) and urinary kininogen-1(KNG1) in the diagnosis of patients with diabetic nephropathy(DN).Methods Two hundred and twenty patients with DN were grouped into simple DN group(n=72),early DN group(n=68) and clinical DN group(n=80) according to Mogensen staging criteria,and 30 healthy subjects for physical examination at the same time were included as control group.The levels of serumα1-MG and urinary KNG1 were compared among the groups.The ROC curves of serum al-MG and urinary KNG1 alone and combination of the two indexes were drawn.The efficacy of serum al-MG and urinary KNG1 alone and combination of the two indexes in diagnosis DN was compared.Results The levels of α1-MG and KNG1 in the simple DN group,the early DN group and the clinical DN group were higher than those in the control group(P <0.05),and the levels of al-MG and KNG1 in the early DN group were higher than those in the simple DN group(P <0.05),and the levels of α1-MG and KNG1 in the clinical DN group were higher than those in the early DN group(P <0.05).The AUC of serum α1-MG diagnosis was lower than that of urinary KNG1 and combined diagnosis(P <0.05),and the AUC of urinary KNG1 diagnosis was lower than that of combined diagnosis(P <0.05).The sensitivity,specificity,accuracy rate and positive and negative predictive values of urinary KNG1 were higher than those of serum al-MG,and the sensitivity,specificity,accuracy rate and positive and negative predictive values of combined detection were higher than those of single detection of serum al-MG and urinary KNG1.Conclusion Serum α1-MG combined with urinary KNG1 for DN has a good diagnostic value and has a certain clinical application value.

关 键 词：糖尿病肾病 诊断 Α1-微球蛋白 尿激肽尿1 

分 类 号：R587.1[医药卫生—内分泌] R692[医药卫生—内科学]