Cys C、NGAL联合Angptl4在诊断早期糖尿病肾病中的价值研究  

Study on the Value of Cys C, NGAL Combined with Angptl4 in the Diagnosis of Early Diabetic Nephropathy

作　　者：耿辉[1] 魏雁虹[1] 杨广民[1] GENG Hui;WEI Yanhong;YANG Guangmin(Jilin Provincial People’s Hospital,Changchun 130021,China;不详)

机构地区：[1]吉林省人民医院,吉林长春130021

出　　处：《中国医学创新》2022年第6期11-15,共5页Medical Innovation of China

摘　　要：目的:探讨胱抑素C(Cys C)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、血管生成素样蛋白4(Angptl4)在早期糖尿病肾病中的临床应用价值。方法:回顾性分析2019年3月-2021年3月吉林省人民医院收治的168例2型糖尿病患者的临床资料,依据《糖尿病肾脏疾病临床诊疗中国指南》的诊断标准以及尿蛋白排泄率(UAER)分为单纯糖尿病组100例和糖尿病肾病组68例,同期收集体检中心健康体检者100例作为对照组。检测三组研究对象的Cys C、NGAL、Angptl4水平,比较三者单独检测和联合检测的诊断价值,并分析其与糖尿病肾病分期的相关性。结果:单纯糖尿病组和糖尿病肾病组的糖尿病病程、高血压史、高血脂比较,差异均有统计学意义(P<0.05)。糖尿病肾病组患者的Cys C、NGAL水平均明显高于单纯糖尿病组、对照组,Angptl4水平明显低于单纯糖尿病组、对照组(P<0.05);单纯糖尿病组患者Cys C、NGAL水平均明显高于对照组,Angptl4水平明显低于对照组(P<0.05)。ROC曲线结果显示,三者联合检测的曲线下面积(AUC)为0.903,灵敏度和特异度可达到90.1%、86.8%,优于任意一项单独检测的诊断效能。不同分期糖尿病肾病患者Cys C、NGAL、Angptl4水平比较,差异均有统计学意义(P<0.05)。Spearman 相关性分析结果显示,Cys C、NGAL与糖尿病肾病分期均呈正相关,Angptl4与糖尿病肾病分期呈负相关(P<0.05)。结论:Cys C、NGAL、Angptl4水平与糖尿病肾病的发生、进展密切相关,联合检测可以为疾病的早期诊断提供实验室依据。Objective:To investigate the clinical application value of cystatin C (Cys C),neutrophil gelatinase-associated lipid carrier protein (NGAL) and angiogeninin like protein 4 (Angptl4) in early diabetic nephropathy.Method:The clinical data of 168 patients with type 2 diabetes admitted to Jilin Provincial People’s Hospital from March 2019 to March 2021 were retrospectively analyzed,according to the diagnostic criteria and urinary protein excretion rate (UAER) of Chinese Guidelines for the Clinical Diagnosis and Treatment of Diabetic Kidney Disease,they were divided into simple diabetes group (n=100) and diabetic nephropathy group (n=68),during the same period,100 healthy subjects in the physical examination center were collected as the control group.The levels of Cys C,NGAL and Angptl4 in the three groups were detected,the diagnostic value of the three tests alone and combined was compared,and the correlation between the three tests and the stage of diabetic nephropathy was analyzed.Result:Comparison of diabetes course,history of hypertension and hyperlipidemia between simple diabetes group and diabetic nephropathy group,the differences were statistically significant (P<0.05).The levels of Cys C and NGAL in diabetic nephropathy group were significantly higher than those in simple diabetes group and control group,the level of Angptl4 was significantly lower than that in simple diabetes group and control group (P<0.05);the levels of Cys C and NGAL in simple diabetes group were significantly higher than those in the control group,the level of Angptl4 was significantly lower than that in the control group (P<0.05).The results of ROC curve showed that the area under the curve (AUC) of the three combined detection was 0.903,and the sensitivity and specificity could reach 90.1% and 86.8%,which was better than the diagnostic efficiency of any single detection.Comparison of levels of Cys C,NGAL and Angptl4 in patients with diabetic nephropathy at different stages,the differences were statistically significant (P<0.05).Spear

关 键 词：糖尿病肾病 胱抑素C 中性粒细胞明胶酶相关脂质运载蛋白 血管生成素样蛋白4 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]