糖尿病患者血清和尿液锌-α2-糖蛋白(ZAG)水平检测联合核素肾动态显像在早期肾功能损伤的诊断价值  

Diagnostic Value of Serum and Urine Zinc-α2-Glycoprotein(ZAG)Levels in Diabetic Patients Combined with Radionuclide Renal Dynamic Imaging in the Diagnosis of Early Renal Impairment

作　　者：董艳芳[1] 李华君 王晓蕴[1] 王元松[1] 孙云川[1] 孔五宝 金倩倩 罗英[2] 牛跃龙 赵红 DONG Yan-fang;LI Hua-jun;WANG Xiao-yun;WANG Yuan-song;SUN Yun-chuan;KONG Wu-bao;JIN Qian-qian;LUO Ying;NIU Yue-long;ZHAO Hong(Department of Endocrinology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei Cangzhou 061001,China;Department of Nuclear Medicine,General Hospital of North China Petroleum Administration,Hebei Cangzhou 062550,China)

机构地区：[1]沧州中西医结合医院内分泌科,河北沧州061001 [2]华北石油管理局总医院核医学科,河北沧州062550

出　　处：《现代检验医学杂志》2021年第1期14-17,119,共5页Journal of Modern Laboratory Medicine

基　　金：河北省医学科学研究重点课题计划项目(编号:20191276)。

摘　　要：目的探讨糖尿病患者血清和尿液锌-α2-糖蛋白(zinc-alpha-2-glycoprotein,ZAG)水平检测联合核素肾动态显像在早期肾功能损伤的诊断价值分析。方法收集2016年3月~2017年3月河北省沧州中西医结合医院及华北石油管理局总医院的2型糖尿病患者120例,根据尿清蛋白排泄率(urinary albumin excretion rates,UAER)分为正常清蛋白尿组(Ⅰ组)、微量清蛋白尿组(Ⅱ组)及临床清蛋白尿组(Ⅲ组),并选取同期进行体检的健康人群20例为对照组;四组患者行99mTc-二乙三胺五乙酸(99mTcm-DTPA)检测肾小球滤过率(glomerular filtration rate,GFR)、肾有效血浆流量(effective renal plasma flow,ERPF),同时记录肾功能曲线峰时、半排时间(T1/2)、20min残留率(C20),采用酶联免疫吸附法测定ZAG的血清和尿液浓度。结果与对照组相比Ⅱ组,Ⅲ组Tp出现后延,T1/2延长,C20显著升高,仅有Ⅲ组相比于对照组差异具有统计学意义(t=3.851,P<0.05)。与对照组比较,Ⅰ组GFR,ERPF显著升高,Ⅲ组显著降低;Ⅰ,Ⅱ,Ⅲ组血、尿ZAG均较对照组显著升高,且尿液ZAG升高幅度显著高于血清ZAG,差异均具有统计学意义(t=2.125~3.854,均P<0.05)。结论99mTcm-DTPA肾动态显像联合尿生物标志物ZAG可以检测糖尿病患者早期肾脏损伤程度,以便临床尽早进行医疗干预,改善患者不良预后。Objective To explore the diagnostic value analysis of serum and urine zinc-α2-glycoprotein(zinc-alpha-2-Glycoprotein,ZAG)levels in diabetic patients combined with radionuclide renal dynamic imaging in the diagnosis of earlyrenal damage.Methods A collection of 120 patients with type 2 diabetes from Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine and the General Hospital of North China Petroleum Administration in Hebei Province from March 2016 to March 2017.T2DM patients were classified according to urinary albumin excretion rates(UAER)divided into normal albuminuria group(groupⅠ),microalbuminuria group(groupⅡ)and clinical proteinuria group(groupⅢ),and selected 20 healthy people who went to the hospital for physical examination during the same period as the control Group:four groups of patients underwent 99mTc-diethylenetriaminepentaacetic acid(99mTcm-DTPA)to detect glomerular filtration rate(GFR),effective renal plasma flow(ERPF),and record renal Function curve peak time,half row time(T1/2),20min residual rate(C20),enzymelinked immunosorbent assay was used to determine ZAG serum and urine concentration.Results Compared with the control group,Tp in groupⅡand groupⅢwas delayed,T1/2 was prolonged,and C20 was significantly increased,but only the difference between group Ⅲ and control group was statistically significant(t=3.851,P<0.05).Compared with the control group,GFR and ERPF in groupⅠincreased significantly,and groupⅢdecreased significantly;blood and urine ZAG in groupsⅠ,Ⅱ,and Ⅲ were significantly higher than those in control group,and urine ZAG increased significantly higher than serum ZAG.The differences were statistically significant(t=2.125~3.854,all P<0.05).Conclusion 99mTcm-DTPA renal dynamic imaging combined with urine biomarker ZAG can detect the degree of early kidney injury in diabetic patients,so that clinical intervention can be carried out as soon as possible to improve the poor prognosis of patients,and it is worthy of clinical promotion and application

关 键 词：糖尿病性肾病 锌-α2-糖蛋白 核素肾动态显像 

分 类 号：R587.1[医药卫生—内分泌] R446.112[医药卫生—内科学]