尿微量白蛋白排泄率与UACR在早期糖尿病肾病中的诊断价值  

Diagnostic value of urine albumin excretion rate and UACR on early diabetic kidney disease

作　　者：徐艳丽 邹培 樊晓雁 XU Yan-li;ZOU Pei;FAN Xiao-yan(Department of Clinical Laboratory,Bozhou Hospital of Traditional Chinese Medicine,Bozhou 236814,Anhui,China)

机构地区：[1]亳州市中医院检验科,安徽亳州236814

出　　处：《川北医学院学报》2022年第5期630-633,645,共5页Journal of North Sichuan Medical College

基　　金：安徽省亳州市重点研发计划项目(bzzc2021017)。

摘　　要：目的:探究尿微量蛋白排泄率(UAER)、尿微量白蛋白肌酐比值(UACR)、肌酐(Cr)、尿素氮(BUN)在早期糖尿病肾病(DKD)中的诊断价值。方法:回顾性分析122例2型糖尿病(T2DM)住院患者临床资料,根据是否诊断为早期DKD分为DKD组(n=42)、T2DM组(n=80),另选取同期80名健康体检者为对照组。比较3组基线资料、糖代谢指标[空腹血糖(FPG)、糖化血红蛋白(HbA1c)]、脂代谢指标[甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]、肾功能指标[UAER、UACR、Cr、BUN、预估肾小球滤过率(eGFR)];采用多因素Logistic回归分析探究影响早期DKD发病因素,绘制受试者工作特征曲线(ROC)探究多因素分析中有统计学意义指标对早期DKD诊断价值。结果:3组性别、年龄、体重指数、吸烟史、饮酒史比较,差异均无统计学意义(P>0.05);DKD组糖尿病病程长于T2DM组(P<0.05)。DKD组、T2DM组FPG、HbA1c、TG、LDL-C均高于对照组(P<0.05),其中DKD组HbA1c高于T2DM组(P<0.05),但3组TC比较差异无统计学意义(P>0.05)。DKD组、T2DM组UAER、UACR均高于对照组(P<0.05),且DKD组均高于T2DM组(P<0.05),但3组Cr、BUN、eGFR比较,差异均无统计学意义(P>0.05)。多因素Logistic回归分析显示,UACR、UAER均是早期DKD发病的独立危险因素(P<0.05)。UAER、UACR诊断早期DKD的ROC曲线下面积(AUC)分别为0.968、0.890。结论:UAER、UACR对早期DKD具有较好诊断价值,但Cr、BUN在早期DKD患者中变化可能并不明显。Objective:To explore the diagnostic value of urine albumin excretion rate(UAER),urine albumin creatinine ratio(UACR),creatinine(Cr) and blood urea nitrogen(BUN) on early diabetic kidney disease(DKD).Methods:The clinical data of 122 inpatients with type 2 diabetes mellitus(T2DM) were retrospectively analyzed.According to whether the patients were diagnosed as early DKD,they were divided into 42 cases in DKD group and 80 cases in T2DM group.Another 80 subjects with physical examination during the same period were enrolled as control group.The baseline data, glucose metabolism indicators [fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1 c)],lipid metabolism indicators [triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)] and renal function indicators [UAER,UACR,Cr, BUN,estimated glomerular filtration rate(eGFR)] were compared among the three groups.Multivariate Logistic regression analysis was used to explore the factors affecting the onset of early DKD,and receiver operating characteristic curve(ROC curve) was drawn to explore the diagnostic value of indicators with statistical significance in multivariate analysis on early DKD.Results:There were no statistical differences in the gender, age, body mass index, smoking history and drinking history among the three groups(P>0.05).The duration of diabetes mellitus in DKD group was longer than that in T2DM group(P<0.05).The levels of FPG,HbA1 c, TG and LDL-C in DKD group and T2DM group were significantly higher than those in control group(P<0.05),and the HbA1 c level in DKD group was significantly higher than that in T2DM group(P<0.05),but there was no statistical significance in TC among the three groups(P>0.05).The UAER and UACR were significantly higher in DKD group and T2DM group than those in control group(P<0.05),and the DKD group than the T2DM group(P<0.05),but there were no statistical differences among the three groups in terms of Cr, BUN and eGFR(P>0.05).Multivariate Logistic regression analysis showed that UACR and UAER we

关 键 词：糖尿病肾病 早期诊断 尿微量白蛋白排泄率 尿微量白蛋白肌酐比值 

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