尿足细胞特异性标记蛋白、血清胱抑素C与血清脂蛋白a检测在糖尿病肾病中的诊断价值  

Diagnostic Value of Urinary Podocyte-Specific Marker Protein, Serum Cystatin C and Serum Lipoprotein a Detectionin Diabetic Nephropathy

作　　者：张宇 Zhang Yu(Beijing Changping District Machikou Community Health Service Center,Beijing 102200,China)

机构地区：[1]北京市昌平区马池口社区卫生服务中心,北京102200

出　　处：《中国社区医师》2023年第36期100-102,共3页Chinese Community Doctors

摘　　要：目的:分析尿足细胞特异性标记蛋白(PCX)、血清胱抑素C(Cys-c)与血清脂蛋白a[Lp(a)]检测在糖尿病肾病(DKD)中的诊断价值。方法:选取2020年9月—2022年9月北京市昌平区马池口社区卫生服务中心收治的188例DKD患者作为研究对象,根据尿白蛋白/尿肌酐(ACR)水平分为无蛋白尿组(n=52)、微量蛋白尿组(n=75)、临床蛋白尿组(n=61),选取同期收治的90例无肾病的糖尿病患者作为对照组。检测患者尿PCX、血清Cys-c、血清Lp(a)水平,采用Pearson相关系数分析尿PCX、血清Cys-c与血清Lp(a)和ACR的相关性。采用Logistic回归分析DKD的独立危险因素,并采用受试者工作特征(ROC)曲线分析各指标单独或联合检测在DKD中的诊断价值。结果:对照组尿PCX、血清Cys-c、血清Lp(a)水平<无蛋白尿组<微量蛋白尿组<临床蛋白尿组,差异有统计学意义(P<0.05)。ACR与尿PCX、血清Cys-c、血清Lp(a)水平呈正相关(P<0.05)。尿PCX、血清Cys-c、血清Lp(a)水平是糖尿病患者并发DKD的独立影响因素(P<0.05)。尿PCX、血清Cys-c、血清Lp(a)对DKD均有较好的诊断价值(P<0.05),三者联合检测的曲线下面积为0.901(95%CI 0.863~0.939)。结论:尿PCX、血清Cys-c、血清Lp(a)与DKD严重程度呈正相关,是糖尿病患者并发DKD的独立影响因素,三项指标联合检测对诊断DKD具有较高价值。Objective:To analyze the diagnostic value of urinary podocyte-specific marker protein(PCX),serum cystatin C(Cys-c)and serum lipoprotein a[Lp(a)]detection in diabetic nephropathy(DKD).Methods:A total of 188 DKD patients admitted to Beijing Changping District Machikou Community Health Service Center from September 2020 to September 2022 were selected as the study subjects.According to the urinary albumin/creatinine ratio(ACR)level,they were divided into non-proteinuria group(n=52),micro-proteinuria group(n=75),and clinical proteinuria group(n=61).A total of 90 diabetic patients without nephropathy who were admitted during the same period were selected as the control group.The levels of urine PCX,serum Cys-c and serum Lp(a)were detected.Pearson correlation coefficient was used to analyze the correlation between urine PCX,serum Cys-c,serum Lp(a)and ACR.Logistic regression analysis was used to establish independent risk factors of DKD.The receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of individual or combined detection of each indicator for DKD.Results:The urine PCX,serum Cys-c,and serum Lp(a)levels were ranked as follows:control group<non-proteinuria group<micro-proteinuria group<clinical proteinuria group,and the difference was statistically significant(P<0.05).The ACR was positively correlated with urine PCX,serum Cys-c,and serum Lp(a)levels(P<0.05).Urine PCX,serum Cys-c and serum Lp(a)levels were independent influencing factors for DKD in diabetic patients(P<0.05).Urine PCX,serum Cys-c and serum Lp(a)all had good diagnostic value for DKD(P<0.05),and the area under the curve of the combined detection of the three indicators was 0.901(95%CI 0.863-0.939),which was higher than that of individual detection of each indicator,and the difference was statistically significant(P<0.05).Conclusion:Urine PCX,serum Cys-c,and serum Lp(a)are positively correlated with the severity of DKD and are independent influencing factors for DKD in diabetic patients.The combined detection of

关 键 词：糖尿病肾病 尿足细胞特异性标记蛋白 血清胱抑素C 血清脂蛋白A 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]