血、尿特定蛋白检测在糖尿病肾病早期诊断中的价值  

The Value of Blood and Urine Specific Protein Detection in Early Diagnosis of Diabetic Nephropathy

作　　者：林永发 LIN Yongfa(Laboratory of Yongchun County Traditional Chinese Medicine Hospital,Quanzhou 362600,China)

机构地区：[1]永春县中医院检验科,福建泉州362600

出　　处：《中国医药指南》2023年第35期10-13,共4页Guide of China Medicine

摘　　要：目的探究血、尿特定蛋白在糖尿病肾病早期诊断中的价值。方法选取我院2021年10月至2022年10月期间收治的66例糖尿病肾病患者作为观察组,同期于我院进行体检的66名健康人作为对照组,对所有受试者实施尿液特定蛋白检测,测定尿微量白蛋白(mAlb)、β2微球蛋白(β2-MG)、转铁蛋白(TRF)及血清胱抑素C(Cys-C)检测。比较单一mAlb检测以及上述四项指标联合检测的阳性检出率;采用多因素Logistic回归分析与糖尿病肾病进展相关的代谢因子,绘制ROC曲线分析单一检测与联合检测糖尿病肾病的诊断效能。结果单一检测的阳性检出率为65.15%,联合检测的阳性检出率83.33%(P<0.05);观察组与对照组的mAlb、β2-MG、TRF、Cys-C指标均与对照组存在显著性差异(均P<0.05);多因素Logistic回归分析显示,尿mAlb、β2-MG、TRF以及血Cys-C水平是与糖尿病肾病进展相关的代谢因子;4项指标联合诊断糖尿病肾病的AUC为0.985,95%CI 0.825~0.938,灵敏度、特异度分别为95.36%、92.84%,均高于单一检测(均P<0.05)。结论采用尿mAlb、β2-MG、TRF与血清Cys-C联合检测相比尿微量白蛋白单一检测对糖尿病肾病早期诊断有较高的诊断价值。Objective To explore the value of blood and urine specific proteins in early diagnosis of diabetic nephropathy.Methods A total of 66 patients with diabetic nephropathy admitted to our hospital from October 2021 to October 2022 were selected as the observation group,and 66 healthy people who underwent physical examination in our hospital during the same period were selected as the control group.Urine specific protein detection was performed on all subjects.Urinary microalbumin(mAlb),β2-microglobulin(β2-MG),transferrin(TRF)and serum cystatin C(Cys-C)were measured.The positive rate of single mAlb detection and the combined detection of the above four indicators were compared.Multivariate logistic regression was used to analyze the metabolic factors associated with the progression of diabetic nephropathy,and ROC curve was drawn to analyze the diagnostic efficacy of single detection and combined detection of diabetic nephropathy.Results The positive rate of single detection was 65.15%,and the positive rate of combined detection was 83.33%(P<0.05).There were significant differences in mAlb,β2-MG,TRF and Cys-C indexes between observation group and control group(all P<0.05).Multivariate Logistic regression analysis showed that urinary mAlb,β2-MG,TRF and serum Cys-C levels were the metabolic factors associated with the progression of diabetic nephropathy.The AUC of the four indexes for combined diagnosis of diabetic nephropathy was 0.985,95%CI 0.825-0.938,sensitivity and specificity were 95.36%and 92.84%,respectively,higher than that of single test(all P<0.05).Conclusions The combined detection of urinary mAlb,β2-MG,TRF and serum Cys-C has higher diagnostic value in the early diagnosis of diabetic nephropathy.

关 键 词：糖尿病肾病 尿微量白蛋白 尿Β2微球蛋白 尿转铁蛋白 血清胱抑素C 

分 类 号：R446.1[医药卫生—诊断学]