血清SAA、CysC、ACR及IL-19在2型糖尿病肾脏病诊断中的应用  

Application of serum levels of SAA,CysC,ACR and IL-19 in the diagnosis of type 2 diabetic nephropathy

作　　者：崔娟 陈连连 马莹[1] 李婷[1] 成存相 肖改娥[1] Cui Juan;Chen Lian-lian;Ma Ying;Li Ting;Cheng Cun-xiang;Xiao Gai-e(Department of Laboratory Medicine,Central Municipal Hospital,Xi'an 710003,China;Department of Laboratory Medicine,Northwest University Hospital/Third Municipal Hospital,Xi'an 710018,China)

机构地区：[1]西安市中心医院检验科,710003 [2]西北大学附属医院/西安市第三医院检验科,710018

出　　处：《临床肾脏病杂志》2021年第9期739-743,共5页Journal Of Clinical Nephrology

摘　　要：目的分析血清淀粉样蛋白A(serum amyloid A,SAA)、胱抑素C(Cystatin C,CysC)、尿微量白蛋白与肌酐比值(albumin to creatinine ratio,ACR)及白细胞介素-19(interleukin,IL-19)在2型糖尿病肾脏病(diabetic kidney disease,DKD)诊断中的应用价值。方法本研究于2017年10月至2020年10月选取院内接受治疗的108例2型糖尿病患者作为研究对象,根据患者是否合并DKD将其分为DKD组和糖尿病组,同期选取于院内接受体检的50例相似年龄段健康体检者作为对照组,对比各组的SAA、CysC、ACR及IL-19的表达水平。结果3组的SAA、CysC、ACR及IL-19比较,差异有统计学意义(P<0.05)。组间比较显示,DKD组和糖尿病患者的SAA、CysC、ACR及IL-19表达水平均高于对照组(P<0.05),且DKD组各项血清学指标均高于糖尿病组(P<0.05);DKD组不同肾损伤分期患者的血清学指标比较,差异有统计学意义(P<0.05)。随着患者肾损伤分期的升高,患者的SAA、CysC、ACR及IL-19表达水平也逐渐升高(P<0.05);通过对各血清学指标之间的相关性分析发现,各指标之间呈显著的正相关(P<0.05);SAA、CysC、ACR及IL-19单独检测的诊断准确率分别为65.48%、76.58%、73.81%和69.62%,均明显低于联合检测的92.41%(P<0.05)。结论血清SAA、CysC、ACR及IL-19均可以有效实现对2型DKD的早期诊断,与患者的肾损害程度密切相关,且各指标的联合检测有较高的诊断准确率。Objective To explore the diagnostic values of serum amyloid A(SAA),Cystatin C(CysC),albumin-to-creatinine ratio(ACR)and interleukin-19(IL-19)for type 2 diabetic nephropathy(DN).Methods From October 2017 to October 2020,a total of 108 type 2 diabetics were selected as research subjects.According to the absence and presence of DN,they were divided into two groups of diabetic kidney disease(DKD).Fifty healthy subjects of similar ages receiving routine physical examination were designated as control group to compare the expression levels of SAA,CysC,ACR and IL-19.Results Three groups were significantly different in serum levels of SAA,CysC,ACR and IL-19(P<0.05).Inter-group comparison indicated that DKD group and diabetics had higher expression levels of SAA,CysC,ACR and IL-19 than control group(P<0.05)and serum parameters were higher in DKD group than diabetes group(P<0.05);DKD group had significant differences in serum parameters of patients with varying kidney injury stages(P<0.05).With advancing stages of renal injury,the expression levels of SAA,CysC,ACR and IL-19 gradually spiked(P<0.05);correlation analysis of various serum parameters hinted at a significant positive correlation(P<0.05);the diagnostic accuracy rates of SAA,CysC,ACR,and IL-19 were 65.48%,76.58%,73.81%and 69.62%respectively.All were significantly lower than a combined detection rate of 92.41%(P<0.05).Conclusion Serum levels of SAA,CysC,ACR and IL-19 can effectively achieve an early diagnosis of type 2 DN.It is closely correlated to with the degree of renal damage and combined detection of various parameters offers a high diagnostic accuracy rate.

关 键 词：血清淀粉样蛋白A 胱抑素C 白细胞介素 糖尿病肾脏病 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学] R446.1[医药卫生—临床医学]