尿KIM-1、MCP-1联合Um Alb/Ucr在糖尿病早期肾损伤中的诊断价值  

Diagnostic value of urinary KIM-1,MCP-1 combined with Um Alb/Uer in diabeties mellitus with early renal injury

作　　者：田晓琴 秦迎雪 王晓光 王立强 Tian Xiaoqin;Qin Yingxue;Wang Xiaoguang;Wang Liqiang(Department of Endocrinology,Liaocheng Central Hospital,Liaocheng 252000,China)

机构地区：[1]聊城市中心医院内分泌科,252000

出　　处：《国际泌尿系统杂志》2020年第5期852-856,共5页International Journal of Urology and Nephrology

基　　金：山东省医药卫生科技发展计划项目(2017WS0276)。

摘　　要：目的探讨尿肾损伤分子1(KIM-1)、单核细胞趋化蛋白-1(MCP-1)联合尿微量白蛋白/尿肌酐(Um Allb/Ucr)在糖尿病(DM)早期肾损伤中的诊断价值。方法选取2017年9月至2019年3月收治的DM患者132例,其中56例伴有早期肾损伤患者为早期肾损伤组,76例无肾损伤患者为单纯DM组,同时选择60例同期体检健康者为对照组。采用酶联免疫吸附法检测尿KIM-1、MCP-1、Uer水平,采用免疫散射比浊法检测Um Alb水平,观察三组受试者尿KIM-1、MCP-1、Um Alb/Uer变化;分析尿KIM-1、MCP-1、Um Allb/Uar与相关生化指标相关性及对DM肾损伤诊断价值。结果早期肾损伤组、单纯DM组患者尿KIM-1 MCP-1、Um Alb/Ucr均高于对照组(P<0.05),早期肾损伤组明显高于单纯DM组(P<0.05);早期肾损伤组、单纯DM组患者血清肌F(Ser)、胱抑素C(Cys C)、β2-微球蛋白(β2-MG)、糖化血红蛋白(HbAlc)均高于对照组(P<0.05),早期肾损伤组显著高于单纯DM组(P<0.05);尿KIM-1、MCP-1、Um.Alb/Uer与Scr、Cys C、β2-MG、HbA1c均呈正相关(P<0.05);尿KIM-1、MCP-1、Um Alb/Uer联合检测对DM早期肾损伤AUC、敏感性、特异性、约登指数高于单-指标检测。结论DM早期肾损伤患者尿KIM-1、MCP-1.Um Alb/Ucr水平升高,三者联合检测对DM早期肾损伤具有较高诊断价值。Objective To investigate the diagnostic value of urinary kidney injury molecule-1(KIM-1),monocyte chemoattractant protein-1(MCP-1)combined urinary microalbumin/urinary creatinine(Um Alb/Ucr)in diabetes mellitus(DM)with early renal injury.Methods From September 2017 to March 2019,132 patients with DM admitted to the department of endocrinology in our hospital were selected for the study,among them,56 patients with early kidney injury were in the early kidney injury group,the other 76 patients without kidney injury were in the simple DM group,and another 60 healthy people in the same period were selected as the normal control group.The levels of urinary KIM-1,MCP-1 and Ucr were detected by ELISA,Um Alb level was detected by immunoscattering turbidimetry.The changes of urinary KIM-1,MCP-1,Um Alb/Ucr and related biochemical indexes were observed in three groups,and the correlations between urinary KIM-1,MCP-1,Um Alb/Ucr and related biochemical indicators,and their diagnostic values of renal injury in patients with diabetes mellitus were analyzed.Results The urinary KIM-1,MCP-1 and Um Alb/Ucr in the early renal injury group and the simple DM group were higher than those in the control group(P<0.05),and the urinary KIM-1,MCP-1 and Um Alb/Ucr in the early renal injury group were significantly higher than those in the simple DM group(P<0.05).The levels of serum creatinine(Scr),cystatin C(Cys C),β2-microglobulin(β2-MG),glycosylated hemoglobin(HbA1c)in the early renal injury group and the simple DM group were higher than those in the control group(P<0.05),and early renal injury group was significantly higher than DM group(P<0.05).Urine KIM-1,MCP-1,Um Allb/Uer were positively correlated with Scr,Cys C,β2-MG and HbA1c(P<0.05).The AUC,sensitivity,specificity and Yoden index of the com-bined detection of urinary KIM-1,MCP-1 and Um Alb/Ucr in for early renal injury were higher than those of single index detections.Conclusions The levels of urinary KIM-1,MCP-1 and Um Alb/Ucr in patients with diabetic renal injury are elevated

关 键 词：糖尿病 肾损伤 肾损伤分子1 单核细胞化学吸引蛋白质类 尿微量白蛋白/尿肌酐 

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