RBP、CysC及ACR联合检测对糖尿病肾病早期诊断价值  

Clinical Value of RBP,CysC and ACR in the Early Diagnosis of Diabetes Nephropathy

作　　者：任明[1] 吕岩[1] 代云峰[1] 张一馨 武悦 REN Ming;LYU Yan;DAI Yunfeng;ZHANG Yixin;WU Yue(Department of Clinical Laboratory,the Second Affiliated Hospital of Qiqihar Medical University,Qiqihar Heilongjiang 161006,China)

机构地区：[1]齐齐哈尔医学院附属第二医院检验科,黑龙江齐齐哈尔161006

出　　处：《中国卫生标准管理》2023年第11期103-106,共4页China Health Standard Management

基　　金：齐齐哈尔市科学技术计划项目(SFGG-201937)。

摘　　要：目的探讨血清视黄醇结合蛋白(retinol blinding protein,RBP)、胱抑素C(cystatin C,Cys C)及尿白蛋白肌酐比(albumin-to-creatinine ratio,ACR)水平三者联合检测对2型糖尿病肾病患者的早期诊断价值。方法本研究选取2018年1月—2021年8月齐齐哈尔医学院附属第二医院收治的58例2型糖尿病肾病患者作为DN组,同时选择在本院治疗的58例单纯2型糖尿病患者作为DM组。使用检验科全自动生化分析仪来检测患者的血清RBP、CysC及尿ACR水平。结果DN组患者血清RBP、CysC及尿ACR水平明显高于DM组,差异有统计学意义(P<0.0.5)。进一步分析DN组及DM组患者RBP、CysC及ACR水平对2型糖尿病患者发生肾病的早期诊断价值,以肾小球滤过率<90 mL/min作为2型糖尿病肾病诊断切点。结果显示,血清RBP、CysC及尿ACR水平的诊断最佳切点分别为2.9 mg/L、1.8 mg/L及86.2 mg/g,三者联合检测可显著提高诊断敏感性及特异性,差异有统计学意义(P<0.05)。结论2型糖尿病患者在早期出现肾损伤时,血清RBP、CysC及尿ACR水平明显升高,三者联合检测对2型糖尿病的早期诊断有着重要意义。Objective To explore the clinical value of combined detection of serum retinol blinding protein(RBP),cystatin C(Cys C),and urinary albumin-to-creatinine ratio(ACR)levels in the early diagnosis of type 2 diabetes nephropathy.Methods This study selected 58 patients with type 2 diabetes nephropathy admitted to the Second Affiliated Hospital of Qiqihar Medical University from January 2018 to August 2021 as the DN group,and 58 patients with simple diabetes admitted to our hospital as the DM group.The automatic biochemical analyzer detects the serum RBP,CysC,and urine ACR levels of patients.Results The levels of serum RBP,CysC,and urinary ACR in the DN group were significantly higher than those in the DM group,with statistical significance(P<0.05).To further analyze the early diagnostic value of RBP,CysC and ACR levels in DN group and DM group for type 2 diabetes nephropathy,the glomerular filtration rate<90 mL/min was taken as the cut-off point for type 2 diabetes nephropathy.The results showed that the optimal cutoff points for the diagnosis of serum RBP,CysC,and urinary ACR levels were 2.9 mg/L,1.8 mg/L,and 86.2 mg/g,respectively.The combined detection of the three significantly improved diagnostic sensitivity and specificity,and the difference was statistically significant(P<0.05).Conclusion The levels of RBP,CysC and urinary ACR in patients with type 2 diabetes are significantly increased when early renal injury occurs.The combined detection of RBP,CysC and urinary ACR is of great significance for the early diagnosis of type 2 diabetes.

关 键 词：视黄醇结合蛋白 胱抑素C 尿白蛋白肌酐比 糖尿病肾病 诊断价值 预测 

分 类 号：R197[医药卫生—卫生事业管理]