血清肾胺酶、尿调节素、可溶性尿激酶受体联合检测对糖尿病肾损伤早期诊断的价值分析  

Analysis of the value of combined detection of serum renalase,uromodulin and soluble urokinase receptor in the early diagnosis of diabetic kidney injury

作　　者：孟莉[1] 舒丽红[2] 周振科[1] 范杰[3] MENG Li;SHU Lihong;ZHOU Zhenke;FAN Jie(Emergency Department,Chengdu Seventh People's Hospital,Chengdu,Sichuan 610000,China;Laboratory Department,Chengdu Seventh People's Hospital,Chengdu,Sichuan 610000,China;Department of Radiology,Chengdu Seventh People's Hospital,Chengdu,Sichuan 610000,China)

机构地区：[1]成都市第七人民医院急诊科,四川成都610000 [2]成都市第七人民医院检验科,四川成都610000 [3]成都市第七人民医院放射科,四川成都610000

出　　处：《安徽医药》2024年第1期148-153,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探究血清肾胺酶(RNLS)、尿调节素(UMOD)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)联合检测对糖尿病肾损伤早期诊断的价值。方法选取2020年3月至2021年3月成都市第七人民医院收治的61例糖尿病肾损伤病人为糖尿病肾损伤组,按24 h尿白蛋白排泄率(UAER)分为早期糖尿病肾病组(29例)和临床期糖尿病肾病组(32例),选取66例糖尿病病人为单纯糖尿病组,另选取同期健康体检者60例为对照组。收集病人的一般临床资料并比较,采用尿素酶法检测血清尿素(UREA),氧化酶法检测肌酐(Cr)和尿酸(UA)水平,采用酶联免疫吸附法(ELISA)检测血清RNLS、UMOD、suPAR的水平。Pearson相关性分析RNLS、UMOD、suPAR与UREA、Cr、UA以及临床资料的关系。采用受试者操作特征(ROC)曲线分析血清RNLS、UMOD、suPAR联合检测对糖尿病病人发生肾损伤的诊断价值。结果糖尿病肾损伤组、单纯糖尿病组三酰甘油、总胆固醇、空腹血糖、糖化血红蛋白及血清UREA、Cr、UA、suPAR水平[(133.56±42.68)ng/L,(66.48±17.13)ng/L比(34.15±8.26)ng/L]均显著高于对照组(P<0.05),估算肾小球滤过率(eGFR)及血清RNLS[(28.62±7.61)mg/L,(35.47±9.29)mg/L比(42.81±13.24)mg/L]、UMOD水平[(64.28±16.82)g/L,(119.45±28.65)g/L比(139.82±32.84)g/L]均显著低于对照组(P<0.05);且糖尿病肾损伤组较单纯糖尿病组升高或下降幅度大(P<0.05)。糖尿病肾损伤组糖尿病病程显著高于单纯糖尿病组(P<0.05),24 h尿蛋白显著高于单纯糖尿病组和对照组(P<0.05)。临床期糖尿病肾病组病人血清RNLS[(26.28±6.69)mg/L比(31.18±8.34)mg/L]、UMOD水平[(51.26±14.41)g/L比(78.65±19.49)g/L]较早期糖尿病肾病组均显著降低(P<0.05),suPAR水平[(151.96±48.03)ng/L比(113.27±36.81)ng/L]显著升高(P<0.05)。RNLS、UMOD与UREA、Cr、UA、三酰甘油、总胆固醇、空腹血糖、糖化血红蛋白、糖尿病病程及24 h尿蛋白均呈负相关(P<0.05),与eGFR呈正相关(P<0.05);suPAObjective To explore the value of combined detection of serum renalase(RNLS),uromodulin(UMOD),and soluble uroki⁃nase-type plasminogen activator receptor(suPAR)in the early diagnosis of diabetic kidney injury.Methods Sixty-one patients with di⁃abetic kidney injury admitted to Chengdu Seventh People's Hospital from March 2020 to March 2021 were selected as the diabetic kid⁃ney injury group.According to the 24 h urinary albumin excretion rate(UAER),they were assigned into early diabetic nephropathy group(29 cases)and clinical diabetic nephropathy group(32 cases).Sixty-six patients with diabetes were selected as the simple diabe⁃tes group,and another 60 healthy persons with physical examination during the same period were selected as the control group.The general clinical data of the patients were collected and compared.Urease method was used to detect serum urea(UREA),oxidase meth⁃od was used to detect creatinine(Cr)and uric acid(UA),enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum RNLS,UMOD and suPAR.Pearson correlation was used to analyze the relationship between RNLS,UMOD,suPAR and UREA,Cr,UA,clinical data.The receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of the combined detec⁃tion of serum RNLS,UMOD,and suPAR for kidney injury in diabetic patients.Results The levels of triacylglycerols,total cholesterol,fasting blood glucose,glycosylated hemoglobin and serum UREA,Cr,UA,suPAR[(133.56±42.68)ng/L,(66.48±17.13)ng/L vs.(34.15±8.26)ng/L]in diabetes kidney injury group and simple diabetes group were significantly higher than those in the control group(P<0.05),and the estimated glomerular filtration rate(eGFR)and serum RNLS[(28.62±7.61)mg/L,(35.47±9.29)mg/L vs.(42.81±13.24)mg/L],UMOD levels[(64.28±16.82)g/L,(119.45±28.65)g/L vs.(139.82±32.84)g/L]were significantly lower than those in the control group(P<0.05);and the renal injury group of diabetes increased or decreased significantly compared with the simple diabetes group(P<0.05).

关 键 词：糖尿病肾病 受体 尿激酶型纤溶酶原激活物 血尿素氮 肌酸酐 肾胺酶 尿调节素 

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