尿微量白蛋白联合β2微球蛋白在诊断糖尿病肾病中的价值  

The Value of Urinary Microalbumin Combined with β2 Microglobulin in the Diagnosis of Diabetic Nephropathy

作　　者：陈文青 叶峰山[1] 宋育明[1] CHEN Wenqing;YE Fengshan;SONG Yuming(The First Affiliated Hospital of Xiamen University,Xiamen,Fujian Province,361003 China)

机构地区：[1]厦门大学附属第一医院,福建厦门361003

出　　处：《糖尿病新世界》2022年第13期32-35,39,共5页Diabetes New World Magazine

摘　　要：目的 探讨尿微量白蛋白联合β2微球蛋白在糖尿病肾病患者中的诊断价值。方法 选择2019年4月—2021年4月厦门大学附属第一医院收治的疑似糖尿病肾病患者96例为研究对象,采用全自动生化分析仪测定患者尿微量白蛋白水平;采用免疫比浊法测定患者β2微球蛋白水平。以病理活检结果作为“金标准”,分析尿微量白蛋白、β2微球蛋白及二者联合在糖尿病肾病中的诊断检出率;绘制ROC曲线,分析不同检测指标的诊断效能。结果 96例疑似糖尿病肾病患者经病理检查确诊71例,确诊率为73.96%。尿微量白蛋白检查准确度为77.08%,灵敏度为77.46%(55/71),特异度为76.00%(19/25)。β2微球蛋白检查准确度为79.17%,灵敏度为81.69%(58/71),特异度为72.00%(18/25)。尿微量白蛋白联合β2微球蛋白检查准确度为91.67%,灵敏度为92.96%(66/71),特异度为88.00%(22/25)。ROC曲线结果表明,尿微量白蛋白联合β2微球蛋白用于糖尿病肾病患者中准确度、灵敏度、特异度、阳性及阴性预测值高于尿微量白蛋白、β2微球蛋白,差异有统计学意义(χ~2=5.914、7.361、6.093、8.562、6.141,P<0.05)。结论 尿微量白蛋白、β2微球蛋白用于糖尿病肾病中具有较高的检出率,且二者联合诊断能获得较高的灵敏度、特异度。Objective To investigate the diagnostic value of urinary microalbumin combined with β2-microglobulin in patients with diabetic nephropathy.Methods A total of 96 patients with suspected diabetic nephropathy admitted to the First Affiliated Hospital of Xiamen University from April 2019 to April 2021 were selected as the study subjects,and the urine microalbumin levels of the patients were measured by automatic biochemical analyzer.The level of β2-microglobulin in patients was determined by immunoturbidimetry.Using pathological biopsy results as the "gold standard",the diagnostic detection rates of urinary microalbumin,β2-microglobulin and their combination in diabetic nephropathy were analyzed.The ROC curve was drawn to analyze the diagnostic efficacy of different detection indicators.Results Of the 96 patients with suspected diabetic nephropathy,71 were confirmed by pathological examination,and the confirmed rate was 73.96%.The accuracy of urine microalbumin test was 77.08%,the sensitivity was 77.46%(55/71),and the specificity was 76.00%(19/25).The detection accuracy of β2 microglobulin was79.17%,the sensitivity was 81.69%(58/71),and the specificity was 72.00%(18/25).The accuracy of urine microalbumin combined with β2 microglobulin was 91.67%,the sensitivity was 92.96%(66/71),and the specificity was88.00%(22/25).The ROC curve results showed that the accuracy,sensitivity,specificity,positive and negative predictive value of urinary microalbumin combined with β2 microglobulin in patients with diabetic nephropathy were higher than those of urinary microalbumin and β2 microglobulin,the difference was statistically significant(χ~2=5.914,7.361,6.093,8.562,6.141,P<0.05).Conclusion Urine microalbumin and β2 microglobulin have a high detection rate in diabetic nephropathy,and the combined diagnosis of the two can obtain high sensitivity and specificity.

关 键 词：尿微量白蛋白 Β2微球蛋白 糖尿病肾病 诊断价值 病理活检 

分 类 号：R59[医药卫生—内科学]