尿蛋白与尿肌酐的比值、β2微球蛋白及视黄醇结合蛋白联合检测对糖尿病肾病的早期诊断价值  

Value of combined detection of urinary albumin-to-creatinine ratio,β2 microglobulin and retinol binding protein in early diagnosis of diabetic nephropathy

作　　者：徐刚 XU Gang(Department of Clinical Laboratory,Baoshan Branch of Renji Hospital in Shanghai,200436)

机构地区：[1]上海市仁济医院宝山分院检验科,上海200436

出　　处：《实用临床医药杂志》2020年第21期86-89,共4页Journal of Clinical Medicine in Practice

基　　金：上海市科学技术委员会科研项目(11DZ1931500)。

摘　　要：目的探讨尿蛋白与尿肌酐的比值(ACR)、β2微球蛋白(β2-MG)及视黄醇结合蛋白(RBP)联合检测对糖尿病早期肾损害的诊断价值。方法选取在本院接受治疗的96例糖尿病患者为研究对象,按照尿蛋白定性试验结果分为糖尿病肾病组(n=49)和单纯糖尿病组(n=47),另选同期门诊健康体检者50例为健康组。检测并比较3组尿ACR、β2-MG和RBP水平,并计算上述指标联合检测及单项检测的敏感度、特异度及准确度。结果糖尿病肾病组ACR、β2-MG及RBP水平高于单纯糖尿病组和健康组,差异均有统计学意义(P<0.05)。糖尿病肾病组ACR、β2-MG、RBP单独及联合检测阳性率均高于单纯糖尿病组(P<0.05)。ACR、β2-MG、RBP联合检测诊断糖尿病肾病的敏感度、特异度及准确度分别为95.92%、85.57%及89.04%,其中联合检测的敏感度和准确度与单项检测比较,差异均有统计学意义(P<0.05),但特异度差异无统计学意义(P>0.05)。结论尿ACR、β2-MG、RBP水平可反映糖尿病早期肾损伤程度,联合检测辅助诊断糖尿病肾病的敏感度和准确度更高。Objective To investigate the value of urinary albumin-to-creatinine ratio(ACR),β2 microglobulin(β2-MG)and retinol binding protein(RBP)in early diagnosis of renal damage in diabetic patients.Methods A total of 96 patients with diabetes who were treated in our hospital were selected as research objects,and were divided into diabetic nephropathy group(n=49)and diabetes group(n=47)according to the qualitative test results of urinary protein.Another 50 healthy patients who underwent physical examination in the outpatient department during the same period were selected as healthy group.The levels of ACR,β2-MG and RBP were detected and compared in three groups,and sensitivity,specificity and accuracy of detection of ACR,β2-MG or RBP alone and their combination were calculated.Results The levels of urinary ACR,β2-MG and RBP in the diabetic nephropathy group were significantly higher than those in diabetes group and healthy group(P<0.05).The positive rates of detection of ACR,β2-MG or RBP alone and their combination in the diabetic nephropathy group were significantly higher than that in the diabetes group(P<0.05).The sensitivity,specificity and accuracy of combined detection of urinary ACR,β2-MG and RBP in diagnosis of diabetic nephropathy were 95.92%,85.57%and 89.04%,respectively,and there were significant differences in sensitivity and accuracy between single detection and combined detection(P<0.05),but no significant difference was found in specificity(P>0.05).Conclusion Urinary ACR,β2-MG and RBP levels can reflect early renal injury degree in diabetic patients,and combined detection has better sensitivity and accuracy in diagnosis of diabetic nephropathy.

关 键 词：尿蛋白与尿肌酐的比值 Β2微球蛋白 视黄醇结合蛋白 联合检测 早期糖尿病 肾损害 

分 类 号：R587.2[医药卫生—内分泌]