尿微量白蛋白/肌酐、脂蛋白a、同型半胱氨酸水平与糖尿病肾病关联性及临床表达意义  

Study on the relationship between urinary microalbumin/creatinine,lipoprotein a,homocysteine and diabetes nephropathy

作　　者：王银艳 原双 赵亚楠[1] 吴迁[1] 邢琳琳 WANG Yinyan;YUAN Shuang;ZHAO Yanan;WU Qian;XING Linlin(Department of Endocrinology,Qingdao Eighth People’s Hospital,Qingdao Shandong266121,China)

机构地区：[1]青岛市第八人民医院内分泌科,山东青岛266121

出　　处：《中国实验诊断学》2024年第3期307-311,共5页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨尿微量白蛋白/肌酐(UmAlb/UCR)、脂蛋白a[Lp(a)]、同型半胱氨酸(Hcy)水平与糖尿病肾病(DN)的关联性及临床表达意义。方法回顾性选取2019年1月至2021年12月青岛市第八人民医院81例DN患者设为研究组,另选取同期收治的81例单纯2型糖尿病(T2DM)患者设为对照组。抽取所有患者尿液及血液样本,经免疫比浊法检测计算UmAlb/UCR,经胶乳增强免疫比浊法测定Lp(a)水平,采取酶循环法测定Hcy水平。统计研究组与对照组、研究组不同疾病分期及不同预后患者UmAlb/UCR、Lp(a)、Hcy水平,分析UmAlb/UCR、Lp(a)、Hcy与DN分期关联性,基于Logistic分析UmAlb/UCR、Lp(a)、Hcy与DN预后的关系。结果研究组UmAlb/UCR、Lp(a)、Hcy水平高于对照组(P<0.05);临床期DN患者UmAlb/UCR、Lp(a)、Hcy水平高于早期DN患者,差异有统计学意义(P<0.05);Pearson检验可知,UmAlb/UCR、Lp(a)、Hcy水平与DN疾病分期存在显著正相关关系(P<0.05);预后不良者糖尿病病程、DN病程、疾病分期及UmAlb/UCR、Lp(a)、Hcy水平高于预后良好者(P<0.05);Logistic回归分析证实,糖尿病病程、DN病程、疾病分期及UmAlb/UCR、Lp(a)、Hcy水平均为DN预后不良的重要影响因素(P<0.05)。结论DN患者UmAlb/UCR、Lp(a)、Hcy水平异常增高,其增高幅度与疾病分期正相关,且UmAlb/UCR、Lp(a)、Hcy水平为DN预后重要影响因素。Objective To investigate the relationship between urinary microalbumin/creatinine(UmAlb/UCR),lipoprotein a[Lp(a)],homocysteine(Hcy)levels and diabetes nephropathy(DN)and their clinical significance.Methods The clinical data of 81patients with DN in Department of Endocrinology,Qingdao Eighth People’s Hospital hospital from January 2019to December 2021were retrospectively selected as the study group,and the clinical data of 81patients with simple type 2diabetes(T2DM)admitted in the same period were selected as the control group.Urine and blood samples were taken from all patients.UmAlb/UCR was detected and calculated by immunoturbidimetry.Lp(a)level was measured by latex enhanced immunoturbidimetry,and Hcy level was measured by enzyme circulation method.Statistic the level of UmAlb/UCR,Lp(a),Hcy of patients with different disease stages and different prognosis in the study group and the control group,analyze the correlation between UmAlb/UCR,Lp(a),Hcy and DN stages,and analyze the relationship between UmAlb/UCR,Lp(a),Hcy and DN prognosis based on Logistic.Results The levels of UmAlb/UCR,Lp(a)and Hcy in the study group were higher than those in the control group(P<0.05).The levels of UmAlb/UCR,Lp(a)and Hcy in clinical DN patients were higher than those in early DN patients(P<0.05).Pearson test showed that the levels of UmAlb/UCR,Lp(a),Hcy were significantly positively correlated with DN disease stage(P<0.05).The course of diabetes,DN course,disease stage,and the levels of UmAlb/UCR,Lp(a),Hcy in patients with poor prognosis were higher than those with good prognosis(P<0.05).Logistic regression analysis confirmed that the course of diabetes,the course of DN,the stage of disease,and the levels of UmAlb/UCR,Lp(a),Hcy were important factors for the poor prognosis of DN(P<0.05).Conclusion The levels of UmAlb/UCR,Lp(a)and Hcy in patients with DN are abnormally increased,and the extent of increase is positively related to the disease stage.The levels of UmAlb/UCR,Lp(a)and Hcy are important prognostic factors for DN.

关 键 词：糖尿病肾病 尿微量白蛋白/肌酐 脂蛋白A 同型半胱氨酸 

分 类 号：R587.2[医药卫生—内分泌]