尿液肾小管上皮细胞在糖尿病肾小管损伤中的应用评估  

Application of urinary tubular epithelial cells in the renal tubular injury in diabetes mellitus

作　　者：袁金玲[1] 伍勇[1] 曹宇星 李颖佳[1] 关卓爵 朱云英 廖金凤 Yuan Jinling;Wu Yong;Cao Yuxing;Li Yingjia;Guan Zhuojue;Zhu Yunying;Liao Jinfeng(Department of Clinical Laboratory,Xiangya Third Hospital,Affiliated to Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院检验科,长沙410013

出　　处：《中华检验医学杂志》2020年第3期317-321,共5页Chinese Journal of Laboratory Medicine

摘　　要：目的:应用尿有形成分分析仪检测肾小管上皮细胞,探讨肾小管上皮细胞在糖尿病肾小管损伤中的临床价值。方法:病例对照研究。收集中南大学湘雅三医院2018年10月至2019年4月体检和住院患者尿液标本452例(其中对照组252例,糖尿病无肾损伤组113例,糖尿病肾损伤组87例),采用UF-5000尿有形成分分析仪检测所有患者标本,以人工镜检法为参考方法,建立正常人群参考范围,采用Kappa一致性分析评估UF-5000检测肾小管上皮细胞的能力;ROC曲线分析肾小管上皮细胞对糖尿病患者的肾小管损伤的诊断价值;采用Kruskal-Wallis检验、卡方检验分析多个样本中位数和率的比较。结果:UF-5000尿有形成分分析仪检测肾小管上皮细胞的参考范围为:0~1.7个/μl。仪器法和人工镜检法两种方法的结果进行Kappa一致性分析,Kappa值为0.699,P>0.05,二者具有较高一致性;ROC曲线分析得出cut-off值为1.7个/μl时,该值所对应的敏感度为0.791,特异度为0.817,ROC曲线下面积为0.861;健康对照组、糖尿病无肾损伤组和糖尿病肾损伤组肾小管上皮细胞中位数分别为0.4个/μl、2.0个/μl和2.3个/μl;三组肾小管上皮细胞的检出率分别为2.78%、56.64%和75.86%,与对照组相比,糖尿病无肾损伤组和糖尿病肾损伤组肾小管上皮细胞中位数分布和检出率差异均有统计学意义;糖尿病无肾损伤组和糖尿病肾损伤组肾小管上皮细胞检出率差异也具有统计学意义。结论:UF-5000尿有形成分分析仪检测肾小管上皮细胞与人工镜检法结果具有较高的一致性。与正常人群相比,糖尿病无肾损伤患者尿沉渣中的肾小管上皮细胞阳性率显著增高,可能有助于早期发现肾小管损伤,以利于临床及时进行干预。Objective To evaluate the ability of Sysmex urine automatic analyzer UF-5000 to detect renal tubular epithelial cells,and to explore the value of detection of renal tubular epithelial cells in renal tubular injury of diabetes mellitus.Methods Case control study.452 urine samples were collected from the third Xiangya Third Hospital of Central South University from October 2018 to April 2019(252 in the control group,113 in diabetes without renal injury group and 87 in diabetes with renal injury group).All samples were detected by both UF-5000 and microscopic examination,established reference range for normal population,then contrasted the coincidence rate and uniformity of the two methods,to evaluate the ability of urine automatic analyzer UF-5000 to detect renal tubular epithelial cells,and the diagnostic value of tubular epithelial cells for renal tubular injury in diabetic patients.All statistical analyses were performed using SPSS17.0,Kappa consistency analysis,ROC curve analysis,Kruskal-Wallis test and Chi-square test were used.Results The reference range of renal tubular epithelial cells by Sysmex urine automatic analyzer UF-5000 is 0-1.7/μl.The results of the two methods were analyzed by Kappa consistency analysis.The Kappa value was 0.699,P>0.05,which meant highly consistent.ROC curve analysis showed when cut-off value was 1.7/μl.The sensitivity,specificity and area under ROC curve were 0.791,0.817 and 0.861 respectively.The median of renal tubular epithelial cells was 0.4/μl,2.0/μl and 2.3/μl in the healthy control group,the diabetes without renal injury group and the diabetes with renal injury group,respectively;the positive rate of renal tubular epithelial cells in the three groups were 2.78%,56.64%and 75.86%respectively.Compared with the control group,the median and positive rate of renal tubular epithelial cells in the diabetes without renal injury group and the diabetes with renal injury group were significant different;there was also significant difference in the positive rate of renal tubular e

关 键 词：肾小管上皮细胞 糖尿病 肾小管损伤 

分 类 号：R692[医药卫生—泌尿科学] R587[医药卫生—外科学]