α1-MGU、TG/Cys-C及肾动脉血流动力学参数早期诊断糖尿病肾病的价值  

Value of α1-MGU,TG/Cys-C and renal arterial hemodynamics parameters in early diagnosis of diabetic nephropathy

作　　者：李梦旭 丁锐锋 杨静静 黄帅[1] LI Meng-xu;DING Rui-feng;YANG Jing-jing(Department of Endocrinology,Fuyang Second People's Hospital,Fuyang Anhui 236000,China)

机构地区：[1]阜阳市第二人民医院内分泌科,安徽阜阳236000

出　　处：《临床和实验医学杂志》2024年第7期752-756,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省医学科学研究项目(编号:2020002366)。

摘　　要：目的 探究尿α1-微球蛋白(α1-MGU)、甘油三酯/胱抑素C(TG/Cys-C)比值及肾动脉血流动力学参数早期诊断糖尿病肾病的价值。方法 回顾性纳入2021年4月至2022年3月在阜阳市第二人民医院接受治疗的糖尿病肾病患者51例作为研究组,同时抽取本院接受治疗的单纯糖尿病患者51例作为对照组。分析两组患者的α1-MGU、TG/Cys-C及肾动脉血流动力学参数[肾动脉起始段内径、收缩期峰值流速(Vmax)、阻力指数]情况,收集患者的一般资料(性别、吸烟史、饮酒史、年龄、糖尿病病程、舒张压、收缩压、体重指数、糖化血红蛋白、糖尿病视网膜病变、血尿、尿活动性沉渣)情况分析影响糖尿病肾病发生的因素,并采用受试者工作特征(ROC)曲线探究各指标早期诊断糖尿病肾病的价值。结果 研究组α1-MGU水平为(36.12±5.15) mg/L,高于对照组[(10.89±2.02)mg/L],TG/Cys-C比值为1.23±0.31,低于对照组(2.44±0.45),差异均有统计学意义(P<0.05)。研究组肾动脉起始段内径、Vmax分别为(0.40±0.03)cm、(0.52±0.07)m/s,均低于对照组[(0.46±0.04)0.75±0.03、(0.75±0.03)m/s],阻力指数为0.78±0.06,高于对照组(0.62±0.03),差异均有统计学意义(P<0.05)。经单因素及多因素分析,TG/Cys-C比值、起始段内径、Vmax为患者发生糖尿病肾病的保护因素(P<0.05),α1-MGU、阻力指数、糖尿病视网膜病变、尿活动性沉渣改变、糖尿病病程为患者发生糖尿病肾病的危险因素(P<0.05)。α1-MGU、TG/Cys-C比值、起始段内径、Vmax、阻力指数早期诊断糖尿病肾病的ROC曲线下面积(AUC)分别为0.879、0.886、0.816、0.945、0.945,均具有较高的诊断价值(P<0.05)。结论 α1-MGU、TG/Cys-C比值及肾动脉血流动力学参数可以作为早期诊断糖尿病肾病的有效工具,有助于及早发现和管理糖尿病患者的肾脏健康问题。Objective To investigate the value of urinary α1-microglobulin(α1-MGU),triglyceride/cystatin C(TG/Cys-C) ratio and renal arterial hemodynamic parameters in early diagnosis of diabetic nephropathy.Methods Fifty-one patients with diabetes nephropathy who received treatment in Fuyang Second People's Hospital from April 2021 to March 2022 were retrospectively included as the study group,and 51 patients with simple diabetes who received treatment in the same hospital were selected as the control group.The α1-MGU,TG/Cys-C,renal arterial hemodynamics parameters[renal artery initial diameter,peak systolic flow velocity(Vmax),resistance index] of the two groups of patients were compared and analyzed,the general data(gender,smoking history,history of alcohol consumption,age,diastolic blood pressure,systolic blood pressure,body mass index,hemoglobin A1c,retinopathy,hematuria,active urine sediment,course of diabetes) of the patients was collected,and the influencing factors affecting the occurrence of diabetic nephropathy were explored,and the value of each index in early diagnosis of diabetes nephropathy was discussed by using the receiver operating characteristic(ROC) curve.Results The level of α1-MGU in the study group was(36.12±5.15) mg/L,which was higher than that in the control group[(10.89±2.02) mg/L],and the TG/Cys-C ratio was 1.23±0.31,which was lower than the control group(2.44±0.45),the differences were statistically significant(P<0.05).The initial diameter and Vmax of the renal artery in the study group were(0.40±0.03) cm and(0.52±0.07) m/s,respectively,which were lower than those in the control group [(0.46±0.04) cm,and(0.75±0.03) m/s],RI was 0.78±0.06,which was higher than that in the control group(0.62±0.03),and the differences were statistically significant(P<0.05).Univariate and multivariate analysis showed that TG/Cys-C ratio,initial internal diameter,and Vmax were protective factors for diabetic nephropathy(P<0.05).;α1-MGU,RI,diabetic retinopathy,urinary active sediment changes,and diabetes

关 键 词：糖尿病肾病 尿Α1-微球蛋白 甘油三酯/胱抑素C 肾动脉血流动力学参数 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]