尿κ和λ轻链检测在糖尿病早期肾损伤中的评估价值分析  

Value of urineκandλlight chain detection in early renal injury in diabetes mellitus

作　　者：卢佩 刘海波 何娟 刁艳君 LU Pei;LIU Haibo;HE Juan;DIAO Yanjun(Department of Clinical Laboratory,the First Affiliated Hospital of Air Force Medical University,Xi′an,Shaanxi 710032,China;Department of Clinical Laboratory,Shaanxi Hospital of Traditional Chinese Medicine,Xi′an,Shaanxi 710003,China)

机构地区：[1]空军军医大学第一附属医院检验科,陕西西安710032 [2]陕西省中医医院检验科,陕西西安710003

出　　处：《检验医学与临床》2022年第23期3220-3222,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨尿κ轻链、λ轻链、免疫球蛋白G和转铁蛋白在糖尿病早期肾损伤评估中的临床价值。方法选取空军军医大学第一附属医院2019年6月至2021年9月收治的61例糖尿病患者(观察组)和50例同期健康体检者(对照组)作为研究对象,并根据有无尿微量清蛋白将观察组患者分为非蛋白尿组和蛋白尿组。比较各组尿κ轻链、λ轻链、免疫球蛋白G、转铁蛋白水平及阳性率,评价各指标诊断早期肾损伤的价值。结果观察组尿κ轻链、λ轻链、免疫球蛋白G和转铁蛋白阳性率及检测水平高于对照组,差异均有统计学意义(P<0.05);蛋白尿组尿λ轻链、免疫球蛋白G和转铁蛋白阳性率均高于非蛋白尿组,差异有统计学意义(P<0.05)。受试者工作特征(ROC)曲线分析显示,尿κ轻链、λ轻链、免疫球蛋白G和转铁蛋白评估早期肾损伤的曲线下面积(AUC)分别为0.813、0.847、0.933、0.946,灵敏度和特异度均较高。结论尿κ轻链、λ轻链、免疫球蛋白G和转铁蛋白对糖尿病早期肾损伤评估有重要的临床价值。Objective To investigate the clinical value of urineκlight chain,λlight chain,immunoglobulin G and transferrin in the evaluation of early renal injury in diabetes mellitus.Methods From June 2019 to September 2021,61 diabetic patients(observation group)and 50 healthy subjects(control group)admitted to the First Affiliated Hospital of Air Force Medical University were selected as the research objects.According to urine microalbumin,the observation group was divided into non-proteinuria group and proteinuria group.The levels and positive rates of urineκlight chain,λlight chain,immunoglobulin G and transferrin in each group were compared,and the value of each index in the diagnosis of early renal injury was evaluated.Results The positive rates and detection levels of urineκlight chain,λlight chain,immunoglobulin G and transferrin in the observation group were significantly higher than those in the control group(P<0.05).The positive rates ofλlight chain,immunoglobulin G and transferrin in the proteinuria group were significantly higher than those in the non-proteinuria group(P<0.05).The receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of urineκlight chain,λlight chain,immunoglobulin G and transferrin in the assessment of early renal injury were 0.813,0.847,0.933 and 0.946,respectively,with high sensitivity and specificity.Conclusion Urineκlight chain,urineλlight chain,immunoglobulin G and transferrin have important clinical value in monitoring and predicting the occurrence and development of early renal injury in diabetes mellitus.

关 键 词：糖尿病 早期肾损伤 尿κ轻链 尿λ轻链 尿免疫球蛋白G 尿转铁蛋白 

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