血清胱抑素C、尿β2-微球蛋白和尿转铁蛋白对糖尿病肾病的预测价值  

The predictive values of serum cystatin C,urinaryβ2-microglobulin,and urinary transferrin in diabetic nephropathy

作　　者：杨超[1] 何萍 YANG Chao;HE Ping(Trauma Center and Department of Burns,The First Hospital of China Medical University,Shenyang 110001,China;Clinical Laboratory,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]中国医科大学附属第一医院创伤中心/烧伤科,沈阳110001 [2]北部战区总医院检验科,沈阳110016

出　　处：《中国医科大学学报》2022年第11期1026-1030,共5页Journal of China Medical University

摘　　要：目的探讨血清胱抑素C(Cys-C)、尿β2-微球蛋白(β2-MG)和尿转铁蛋白(UTRF)对糖尿病肾病(DN)的预测价值。方法选取2021年2月至5月中国医科大学附属第一医院内分泌与代谢病科收治的48例DN患者作为DN组,同时选取50例单纯糖尿病(DM)患者作为DM组。比较2组血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A-1(ApoA-1)、载脂蛋白B(ApoB)、脂蛋白a[LP(a)]、胱抑素C(Cys-C)、尿酸(UA)、血浆糖化血红蛋白(HbA1c)、尿β2-MG以及UTRF水平;采用多因素logistic回归分析DN的影响因素。利用受试者操作特征(ROC)曲线分析Cys-C、β2-MG和UTRF对DN的预测价值。结果2组Cys-C、β2-MG、UTRF水平及阳性率比较差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示Cys-C和UTRF是DN的独立危险因素(OR分别为3.222、16.138,95%CI分别为1.025~10.132、5.344~48.731,P分别为0.045、<0.001)。ROC曲线分析结果显示Cys-C、β2-MG和UTRF对DN有较高的诊断价值,其中Cys-C联合UTRF的诊断价值最高(曲线下面积为0.909,95%CI为0.850~0.967,灵敏度为0.917,特异度为0.760)。结论Cys-C、β2-MG和UTRF水平均可反映糖尿病患者肾脏损伤程度,Cys-C和UTRF是影响DN的独立危险因素,Cys-C、β2-MG和UTRF指标对DN均具有预测价值,其中Cys-C联合UTRF的诊断意义最大。Objective To investigate the predictive values of serum cystatin C(Cys-C),urinaryβ2-microglobulin(β2-MG),and urinary transferrin(UTRF)in diabetic nephropathy.Methods Forty-eight patients with diabetic nephropathy(DN)admitted to the Department of Endocrinology and Metabolic Diseases of the First Hospital of China Medical University from February to May 2021 were selected as the DN group,while 50 patients with diabetes mellitus(DM)alone were selected as the DM group.Their clinical data,which included serum triglycerides(TG),serum total cholesterol(TC),serum high-density lipoprotein cholesterol(HDL-C),serum low-density lipoprotein cholesterol(LDL-C),serum apolipoprotein A-1(ApoA-1),serum apolipoprotein B(ApoB),serum lipoprotein a[LP(a)],cystatin C(Cys-C),serum uric acid(UA),plasma glycosylated hemoglobin(HbA1c),urinaryβ2-MG,and UTRF were collected and compared.Multi-factor logistic regression was used to analyze the factors influencing DN.The predictive values of Cys-C,β2-MG,and UTRF on DN were analyzed using receiver operating characteristic(ROC)curves.Results The differences in Cys-C,β2-MG,and UTRF levels and the positivity rates between the two groups were statistically significant(all P<0.05).Multi-factor logistic regression analysis showed that Cys-C and UTRF levels were independent risk factors for DN(all P<0.05).The results of the ROC curve analysis showed that Cys-C,β2-MG,and UTRF had high diagnostic values for DN,with combined Cys-C and UTRF having the highest diagnostic value(area under curve=0.909,95%CI:0.850-0.967,sensitivity=0.917,specificity=0.760).Conclusion Cys-C,β2-MG,and UTRF can reflect the severity of kidney damage in patients with DM.Cys-C and UTRF are independent risk factors for DN.Cys-C,β2-MG,and UTRF levels,all have predictive values for DN,with combined Cys-C and UTRF having the greatest diagnostic significance.

关 键 词：血清胱抑素C 尿Β2-微球蛋白 尿转铁蛋白 糖尿病肾病 预测价值 

分 类 号：R446.11[医药卫生—诊断学]