双肾血流阻力指数联合脂肪特异性丝氨酸蛋白酶抑制剂预测2型糖尿病肾脏疾病患者肾功能的价值  

Value of blood flow resistance index plus Vaspin in predicting renal function in patients with type 2 diabetic nephropathy

作　　者：陆文琪 赵艳茹[1] 李焕娣 樊欣娜[1] 李萍 魏鹍[2] Lu Wen-qi;Zhao Yan-ru;Li Huan-di;Fan Xin-na;Li Ping;Wei Kun(Department of Nutrition,Qinhuangdao First Hospital,Qinhuangdao 066000,China;Department of Nephrology,Qinhuangdao First Hospital,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院营养科,秦皇岛066000 [2]秦皇岛市第一医院肾内科,秦皇岛066000

出　　处：《临床肾脏病杂志》2024年第4期277-283,共7页Journal Of Clinical Nephrology

基　　金：秦皇岛市科学技术研究与发展计划(202101A216)。

摘　　要：目的探讨双肾血流阻力指数联合脂肪特异性丝氨酸蛋白酶抑制剂(visceral adipose tissue-derived serine protease inhibitor,Vaspin)预测2型糖尿病肾脏疾病患者肾功能的价值。方法选取2021年8月至2022年8月秦皇岛市第一医院收治的108例2型糖尿病肾脏疾病患者,入院后进行彩色多普勒超声检查,测量患者双肾血流阻力指数,将患者分为肾血流阻力指数升高组40例和肾血流阻力指数正常组68例。采用酶联免疫吸附试验检测血清Vaspin水平,并搜集患者临床资料;采用单因素和多因素Logistic回归分析影响肾血流阻力指数升高的危险因素。采用Pearson分析肾血流阻力指数、Vaspin与临床资料的关系,根据肾血流阻力指数、Vaspin绘制受试者工作特征曲线,以曲线下面积评估其对2型糖尿病肾脏疾病患者肾功能的预测价值。结果两组患者性别、糖尿病肾脏疾病分期、尿蛋白定量、血白蛋白、糖化血红蛋白、血尿酸、尿白蛋白与肌酐比值、尿α1微球蛋白、尿β2微球蛋白等一般资料比较差异均无统计学意义(P>0.05);肾血流阻力指数升高组患者年龄[(56.33±5.19)岁比(50.78±5.24)岁]、糖尿病病程[(12.58±3.42)年比(10.13±3.25)年]、高血压(87.50%比61.76%)高于肾血流阻力指数正常组,而三酰甘油[(1.72±0.45)mmol/L比(2.11±0.58)mmol/L]、低密度脂蛋白[(2.33±0.57)mmol/L比(2.61±0.62)mmol/L]、血红蛋白[(102.39±21.64)g/L比(113.76±28.45)g/L]、左肾体积[(76.58±15.33)cm^(3)比(81.35±17.16)cm^(3)]、右肾体积[(71.62±12.39)cm^(3)比(80.47±16.51)cm^(3)]、估算肾小球滤过率[(40.37±12.58)mL·min^(-1)·(1.73 m^(2))-1比(52.14±13.26)mL·min^(-1)·(1.73 m^(2))^(-1)]、血清Vaspin水平[(1.52±0.38)μg/L比(1.74±0.43)μg/L]低于肾血流阻力指数正常组(P<0.05)。Pearson相关性分析结果显示,肾血流阻力指数与低密度脂蛋白、估算肾小球滤过率、血清Vaspin呈负相关关系(P<0.05),与血肌酐、尿白蛋白与肌Objective To explore the value of blood flow resistance index of both kidneys plus visceral adipose tissue-derived serine protease inhibitor(Vaspin)in predicting renal function in patients with type 2 diabetic nephropathy(T2DN).Methods From August 2021 to August 2022,108 T2DN pa-tients were recruited.Color ultrasonography was performed after admission for measuring renal indices.They were divided into two groups of elevated blood flow resistance index(n=40)and normal renal index(n=68).Serum level of Vaspin was detected by MeAP immunosorbent assay.The relevant clinical da-ta were recorded.The risk factors affecting an elevation of renal indices were analyzed by univariate and multivariate Logistic regression.Pearson’s method was employed for examining the relationship between renal indices,Vaspin and renal function.Receiver operating characteristic(ROC)curve was plotted according to renal indices and Vaspin.And the area under the curve(AUC)was utilized for evaluating its predictive value of renal function in T2DN patients.Results No significant inter-group differences existed in gender,stage of diabetic kidney disease,quantitative urinary protein,blood albumin,glycosylated hemoglobin,blood uric acid,urinary albumin to creatinine ratio,urinaryα1 microglobulin or urinaryβ2 microglobulin(P>0.05).Age[(56.33±5.19)year vs(50.78±5.24)year],duration of diabetes[(12.58±3.42)years vs(10.13±3.25)years]and hypertension(87.50%vs 61.76%)were higher in elevated renal blood flow resistance index group than those in normal group.Triglyceride[(1.72±0.45)mmol/L vs(2.11±0.58)mmol/L],low-density lipoprotein(LDL)[(2.33±0.57)mmol/L vs(2.61±0.62)mmol/L],hemoglobin[(102.39±21.64)g/L vs(113.76±28.45)g/L],left kidney volume[(76.58±15.33)cm^(3) vs(81.35±17.16)cm^(3)],right kidney volume[(71.62±12.39)cm^(3) vs(80.47±16.51)cm^(3)],estimated glomerular filtration rate(eGFR)[(40.37±12.58)mL·min^(-1)·(1.73 m^(2))-1 vs(52.14±13.26)mL·min^(-1)·(1.73 m^(2))^(-1)]and serum level of Vaspin[(1.52±0.38)μg/L vs(1.74±0.43)μg/L]

关 键 词：糖尿病肾脏疾病 血流阻力 丝氨酸蛋白酶抑制剂 肾功能 

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