尿KIM-1,NGAL及β_(2)-MG在糖尿病肾脏疾病早期诊断中价值研究  

Study on the value of urine KIM-1,NGAL,β_(2)-MG in the early diagnosis of diabetic kidney disease

作　　者：马续祥 王道洋[1] 纵晓英[1] 黄玉萍[1] 丁志珍[1] 李莹[1] 辛玲[1] MA Xuxiang;WANG Daoyang;ZONG Xiaoying;HUANG Yuping;DING Zhizhen;LI Ying;XIN Ling(Department of Nephropathy,the Second Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233000,China)

机构地区：[1]蚌埠医学院第二附属医院肾内科,安徽蚌埠233000

出　　处：《现代医药卫生》2021年第23期4004-4007,共4页Journal of Modern Medicine & Health

基　　金：蚌埠医学院科技发展基金项目(BYKF18117)。

摘　　要：目的探讨2型糖尿病(T2DM)患者尿液中肾损伤分子1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及β_(2)微球蛋白(β_(2)-MG)在糖尿病肾脏疾病(DKD)的早期诊断中价值。方法选择2018年11月至2019年6月入住该院内科并符合受试条件的T2DM患者共60例,并根据尿清蛋白排泄率(UAER)分为微量蛋白尿组(M组,即UAER为20~<200μg/min)30例和大量蛋白尿组(L组,即UAER≥200μg/min)30例,另选取同期该院体检中心健康人员30例作为对照组。检测并比较各组受试者尿液中KIM-1、NGAL、β_(2)-MG水平,同时观察常见肾损伤检测指标血清尿素(BUN),血肌酐(SCr)、胱抑素C(Cys-C)及肾小球滤过率(GFR)指标,采用受试者工作特征曲线评估T2DM患者尿KIM-1、NGAL、β_(2)-MG指标对早期DKD诊断的特异度、敏感度。结果M、L组尿KIM-1、NGAL及β_(2)-MG水平均高于对照组,差异均有统计学意义(P<0.05),其中L组最高。KIM-1、NGAL及β_(2)-MG水平随着BUN、SCr、Cys-C水平的升高和GFR水平的下降而增高,尿KIM-1、NGAL、β_(2)-MG曲线下面积分别为0.631、0.922、0.867。结论尿KIM-1、NGAL、β_(2)-MG对识别早期DKD的发生有一定的临床意义,NGAL敏感度、特异度相对更高。Objective To explore the value in early diagnosis of kidney injury molecule 1(KIM-1),neutrophil gelatinase-associated lipocalin(NGAL)andβ_(2) microglobulin(β_(2)-MG)in urine of patients with type 2 diabetes(T2DM)in diabetic kidney disease(DKD).Methods A total of 60 patients WITH T2DM who were admitted to the Internal Medicine Department of the hospital from November 2018 to June 2019 and met the test conditions were selected,and according to the urinary albumin excretion rate(UAER),them were divided into the microalbuminuria group(M group,UAER was 20-<200μg/min)30 cases and large proteinuria group(L group,UAER≥200μg/min)30 cases,and 30 healthy persons in physical examination center of the hospital were selected as normal controls.The levels of KIM-1,NGAL andβ_(2)-mg in urine were detected,and the results were compared between the experimental group and the control group.Serum urea(BUN),serum creatinine(SCr),Cystatin C(Cys-C)and GFR were observed.The receiver operating characteristic curve was used to evaluate the specificity and sensitivity of urine KIM-1,NGAL,andβ_(2)-MG indicators for early diagnosis of DKD in patients with T2DM.Results The levels of urinary KIM-1,NGAL andβ_(2)-mg in group M and group L were higher than those in the control group,the differences were statistically significant(P<0.05).The levels of KIM-1,NGAL andβ_(2)-MG were increased with the increase of BUN,SCr,Cys-C levels and the decrease of GFR levels.The area under the curve of urinary KIM-1,NGAL andβ_(2)-mg were 0.631,0.922 and 0.867,respectively.Conclusion Urinary KIM-1,NGAL andβ_(2)-mg have certain clinical significance in identifying the occurrence of early DKD,and NGAL is relatively higher in sensitivity and specificity.

关 键 词：糖尿病肾脏疾病 肾损伤分子1 中性粒细胞明胶酶相关脂质运载蛋白 β_(2)微球蛋白 早期诊断 

分 类 号：R446.1[医药卫生—诊断学]