尿液中生物学标记物对糖尿病肾病患者发生急性肾损伤的预测  

Prediction of acute renal injury in patients with diabetes nephropathy by urinary biomarkers

作　　者：郭洋洋 Guo Yangyang(Langfang Fourth People's Hospital,Langfang,Hebei 065700,China)

机构地区：[1]河北省廊坊市第四人民医院,河北廊坊065700

出　　处：《首都食品与医药》2023年第10期53-56,共4页Capital Food Medicine

摘　　要：目的分析糖尿病肾病(DN)患者治疗前尿液中生物学标记物对发生急性肾损伤(AKI)的预测能力.方法选取河北省廊坊市第四人民医院2020年5月-2022年5月86例DNⅢ期患者作为此次研究对象,治疗前所有患者均进行尿液检查,接受饮食、运动及药物等保守治疗.统计患者治疗后AKI的发生情况,分为发生组与未发生组.比较发生组与未发生组患者尿白蛋白(UALB)、单核细胞趋化蛋白1(MCP-1)、肝型脂肪酸结合蛋白(L-FABP)、肾脏损伤分子1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平差异,绘制受试者工作特征曲线(ROC曲线),分析其在AKI发生中的预测效能.结果86例DN患者中,21例(24.42%)发生AKI,65例(75.58%)未发生AKI.发生组L-FABP、KIM-1、NGAL水平均高于未发生组,P<0.05;两组年龄、糖尿病病程、性别、长期饮酒史、体重指数、长期吸烟史、UALB、MCP-1水平对比,差异无统计学意义(P>0.05);Logistic回归分析结果显示,尿L-FABP、KIM-1、NGAL水平过高表达为DN患者发生AKI的危险因素(OR>1,P<0.05);ROC曲线结果显示,尿L-FABP、KIM-1、NGAL水平预测DN患者AKI发生风险的曲线下面积(AUC)均>0.7,具有一定的预测价值,且联合预测价值较高.结论DN患者治疗前尿液中L-FABP、KIM-1、NGAL水平与AKI发生有关,且提前检测尿L-FABP、KIM-1、NGAL水平可预测AKI发生风险,且联合检测的预测准确性更高.Objective To analyze the predictive ability of urine biomarkers in patients with diabetes nephropathy(DN)before treatment for acute renal injury(AKI).Methods 86 patients with DN III in the hospital from May 2020 to May 2022 were selected for this study.Before treatment,all patients underwent urine examination and received conservative treatment such as diet,exercise and drugs.The incidence of AKI after treatment was counted and divided into incidence group and non incidence group.The levels of urinary albumin(UALB),monocyte chemoattractant protein 1(MCP-1),hepatic fatty acid binding protein(L-FABP),kidney injury molecule 1(KIM-1),and neutrophil gelatinase related lipid transporter(NGAL)were compared between the occurrence group and the non occurrence group,and the working characteristic curve(ROC curve)of the subjects was drawn to analyze their predictive efficacy in the occurrence of AKI.Results Among 86 patients with DN,21(24.42%)had AKI and 65(75.58%)had no AKI.The levels of L-FABP,KIM-1 and NGAL in the occurrence group were higher than those in the non occurrence group(P<0.05);there was no significant difference in age,duration of diabetes,gender,long-term drinking history,body mass index,long-term smoking history,UALB,and MCP-1 levels between the two groups(P>0.05);Logistic regression analysis showed that the overexpression of urinary L-FABP,KIM-1 and NGAL was a risk factor for AKI in DN patients(OR>1,P<0.05);the ROC curve results showed that the area under the curve(AUC)of urinary L-FABP,KIM-1 and NGAL levels to predict the risk of AKI in DN patients was greater than O0.7,which had a certain predictive value,and the combined predictive value was high.Conclusion The levels of L-FABP,KIM-1 and NGAL in urine of DN patients before treatment are related to the occurrence of AKI,and the detection of the levels of L-FABP,KIM-1 and NGAL in urine in advance can predict the risk of AKI,and the prediction accuracy of combined detection is higher.

关 键 词：急性肾损伤 糖尿病肾病 肾脏损伤分子1 中性粒细胞 预测 

分 类 号：R446.122[医药卫生—诊断学]