联合血清中性粒细胞明胶酶相关脂质运载蛋白、转铁蛋白以及超敏C-反应蛋白检测诊断糖尿病肾病的价值探讨  

Analysis of the combined detection value of serum NGAL,TRF and hs-CRP in the diagnosis of diabetic nephropathy

作　　者：喻敏[1] 刘春雅[1] 姜毅[1] 陈忆琳 YU Min;LIU Chun-ya;JIANG Yi;CHEN Yi-lin(Department of Nephrology,Quzhou People's Hospital,Quzhou,Zhejiang 324000,China)

机构地区：[1]衢州市人民医院肾内科,浙江衢州324000

出　　处：《中国卫生检验杂志》2020年第23期2890-2893,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的分析联合血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、转铁蛋白(TRF)以及超敏C-反应蛋白(hs-CRP)检测对糖尿病肾病(DN)早期诊断的参考价值。方法选取2017年6月-2019年6月于本院就诊的313例2型糖尿病患者为研究对象,根据患者的尿微量白蛋白排泄率(UACR)将其分成单纯糖尿病(DM)组、早期糖尿病肾病(EDN)组以及临床糖尿病肾病(CN)组,此外选择了150例同期健康体检者为健康对照组。对比分析各组血清NGAL、TRF以及hs-CRP表达水平,对比各指标的参考价值。结果 EDN组和CN组的NGAL和hs-CRP水平均显著高于健康对照组和DM组(P <0.05),而EDN组和CN组的TRF水平均显著低于健康对照组和DM组(P <0.05);血清NGAL、TRF和hs-CRP水平对DN的诊断cut-off值分别为156.24 ng/ml、3.59 g/L和5.17 mg/L,其诊断的AUC分别为0.912、0.784、0.603。联合检测诊断的AUC为0.973,三者联合检测诊断灵敏度显著高于单独的NGAL、TRF和hs-CRP检测方法(P <0.05)。结论联合血清NGAL、TRF以及hs-CRP检测对DN的早期诊断和病情进程具有较好的参考价值,值得在临床上推广应用,以改善DN患者预后。Objective To analyze the reference value of serum neutrophil gelatinase-associated lipocalin( NGAL),transferrin( TRF),and high-sensitivity C-reactive protein( hs-CRP) for the early diagnosis of diabetic nephropathy( DN).Methods A total of 313 patients with type 2 diabetes mellitus who were admitted to our hospital from June 2017 to June 2019 were enrolled. According to the patient’s urinary albumin excretion rate( UACR),they were divided into simple diabetes mellitus( DM) group and early diabetes nephropathy( EDN) group and the clinical diabetic nephropathy( CN) group,150 healthy subjects were selected as the controls. The serum levels of NGAL,TRF and hs-CRP were compared and analyzed,and the reference values of each index were compared. Results The levels of NGAL and hs-CRP in EDN and CN group were significantly higher than those in the control group and DM group( P < 0. 05),while the TRF levels in EDN and CN group were significantly lower than those in the control group and DM group( P < 0. 05);the diagnostic cut-off values of NGAL,TRF and hs-CRP levels for DN were respectively 156. 24 ng/ml,3. 59 g/L and 5. 17 mg/L,and the diagnostic AUC were respectively0. 912,0. 784,0. 603. The diagnostic AUC of the combined test was 0. 973,and the diagnostic sensitivity of the combined detection was significantly higher than that of the NGAL,TRF and hs-CRP( P < 0. 05). Conclusion The combination of serum NGAL,TRF,and hs-CRP has a good reference value for the early diagnosis and progression of DN. It is worthy of clinical application to improve the prognosis of DN patients.

关 键 词：中性粒细胞明胶酶相关脂质运载蛋白 转铁蛋白 超敏C–反应蛋白 糖尿病肾病 

分 类 号：R587.2[医药卫生—内分泌]