血清半乳糖凝集素3、补体C3联合尿足细胞检测早期诊断2型糖尿病患者肾病的临床价值分析  

Clinical value of serum galectin-3 and C3 combined with urinary podocyte detection in early diagnosis of nephropathy in type 2 diabetes mellitus

作　　者：詹碧翠[1] 叶晓强 楼大钧[2] ZHAN Bi-cui;YE Xiao-qiang;LOU Da-jun(Clinical Laboratory,Hangzhou Central Hospital,Hangzhou,Zhejiang 310007,China)

机构地区：[1]杭州市中医院检验科,浙江杭州310007 [2]绍兴市人民医院内分泌科,浙江绍兴312000

出　　处：《中国卫生检验杂志》2020年第14期1671-1675,共5页Chinese Journal of Health Laboratory Technology

基　　金：浙江省医药卫生科技计划项目(2014C33239);浙江省医药卫生科技计划项目(2017RC029)。

摘　　要：目的探讨血清Galectin-3、C3联合尿足细胞检测早期诊断2型糖尿病患者肾病的临床价值。方法选取本院内科就诊的2型糖尿病患者92例为疾病组,依据尿白蛋白/尿肌酐比值分为3组:正常白蛋白尿组(比值<3 mg/mmol)21例,微量白蛋白尿组(比值≥3 mg/mmol且≤30 mg/mmol)52例,大量白蛋白尿组(>30 mg/mmol)19例,同期选择本院门诊健康体检者87例为对照组;测定各组血清肌酐(Scr)、磷(P)、钙(Ca)、血尿素(BUN)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、白蛋白(Alb)、C3、半乳糖凝集素-3(Galectin-3)、hs-CRP及尿微量白蛋白(U-m ALB)、尿足细胞水平。结果正常白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组Galectin-3、C3、尿足细胞、Scr、P、Ca、BUN、hs-CRP水平高于对照组(P<0.05),EGFR水平低于对照组(P<0.05),微量白蛋白尿组、大量白蛋白尿组Galectin-3、C3、尿足细胞、Scr、P、Ca、BUN、hs-CRP水平高于正常白蛋白尿组(P<0.05),EGFR水平低于正常白蛋白尿组(P<0.05);大量白蛋白尿组Galectin-3、C3、尿足细胞、Scr、P、Ca、BUN、hs-CRP水平高于微量白蛋白尿组(P<0.05),EGFR水平低于微量白蛋白尿组(P<0.05),随着糖尿病肾脏损伤程度的加剧,Galectin-3、C3、尿足细胞、Scr、P、Ca、BUN、hs-CRP水平逐渐升高,EGFR水平逐渐降低(P<0.05)。Galectin-3、C3、尿足细胞与Scr、P、Ca、BUN、hs-CRP正相关关系明显(P<0.05),与EGFR负相关关系明显(P<0.05)。高水平的Galectin-3、C3、尿足细胞均为2型糖尿病患者肾病发生的危险因素(P<0.05);C3、Galectin-3两者的AUC相近,皆小于Galectin-3+C3+尿足细胞;C3、Galectin-3诊断2型糖尿病患者期肾病的灵敏度、特异度相近,皆小于Galectin-3+C3+尿足细胞。结论2型糖尿病患者肾病血清Galectin-3、C3、尿足细胞水平升高,其与2型糖尿病患者肾病严重程度密切相关;Galectin-3、C3、联合尿足细胞检测早期诊断2型糖尿病患者肾病具�Objective To investigate the clinical value of serum galectin-3 and C3 combined with urinary podocyte detection in early diagnosis of nephropathy in type 2 diabetes mellitus.Methods Ninety nine patients with type 2 diabetes were selected as the case group.According to the ratio of urinary albumin to urinary creatinine,they were divided into three groups:21 cases in normal albuminuria group(ratio<3 mg/mmol),52 cases in microalbuminuria group(ratio≥3 mg/mmol and<30 mg/mmol),19 cases in massive albuminuria group(ratio>30 mg/mmol),and 87 cases in outpatient health examination group were selected as the control group.Serum creatinine(Scr),phosphorus(P),calcium(Ca),blood urea(BUN),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),albumin(Alb),C3,galectin-3,hs-CRP,urinary microalbumin(U-m ALB),urinary podocyte level in all groups were detected.Results The levels of Galectin-3,C3,urinary podocyte,Scr,P,Ca,BUN and hs-CRP in normal albuminuria group,microalbuminuria group and macroalbuminuria group were higher than those in control group,and the levels of EGFR were lower than that in control group(P<0.05).The levels of Galectin-3,C3,podocyte,Scr,P,Ca,BUN and hs-CRP in microalbuminuria group and macroalbuminuria group were higher than those in normal albuminuria group,while the levels of EGFR were lower(P<0.05).The levels of Galectin-3,C3,urinary podocyte,Scr,P,Ca,BUN,hs-CRP were higher in macroalbuminuria group than those in microalbuminuria group,and the levels of EGFR were lower in microalbuminuria group than those in microalbuminuria group(P<0.05).With the aggravation of diabetic kidney injury,the levels of Galectin-3,C3,podocyte,Scr,P,Ca,BUN and hs-CRP gradually increased,and the levels of EGFR gradually decreased(P<0.05).Galectin-3,C3 and urinary podocytes were positively correlated with Scr,P,Ca,BUN and hs-CRP,and negatively correlated with EGFR(P<0.05).High levels of Galectin-3,C3 and urinary podocyte were risk factors for type 2 diabetic nephropathy(P<0.05);The AUC of C3 and Galectin

关 键 词：半乳糖凝集素-3 补体C3 尿足细胞 2型糖尿病 

分 类 号：R587.2[医药卫生—内分泌]