尿MAU联合血清NGAL、IL-27在糖尿病肾病诊断中的应用价值  

Application value of urine MAU combined with serum NGAL and IL-27 in the diagnosis of diabetes nephropathy

作　　者：杜元 宋雨轩 武智强[1] 孙伟红 DU Yuan;SONG Yuxuan;WU Zhiqiang;SUN Weihong(Department of Laboratory,Baoding No.1 Hospital of TCM,Baoding,Hebei 071000,China)

机构地区：[1]河北省保定市第一中医院检验科,河北保定071000

出　　处：《检验医学与临床》2024年第16期2385-2389,共5页Laboratory Medicine and Clinic

基　　金：河北省保定市科技计划项目(2241ZF076)。

摘　　要：目的 探讨尿微量清蛋白(MAU)联合血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、白细胞介素-27(IL-27)在糖尿病肾病(DN)诊断中的应用价值。方法 选取2021年2月至2022年3月该院收治的50例糖尿病(DM)患者为DM组,选择同期收治的55例DN患者为DN组,同时选取同期在该院体检的年龄匹配的体检健康者60例作为对照组。检测各组研究对象血清NGAL、IL-27、血红蛋白、清蛋白、胱抑素C水平及尿MAU、尿肌酐、24 h尿蛋白定量。采用Pearson相关分析DN患者血清NGAL、IL-27水平与尿MAU水平、24 h尿蛋白定量的相关性;采用受试者工作特征(ROC)曲线分析尿MAU、血清NGAL、血清IL-27单独及联合检测对DN的诊断价值。结果 DM组、DN组血清胱抑素C、尿肌酐、尿MAU、血清NGAL、血清IL-27水平及尿MAU/尿肌酐比值、24 h尿蛋白定量均显著高于对照组,且DN组显著高于DM组,差异均有统计学意义(P<0.05)。DM组、DN组血清清蛋白、血红蛋白水平显著低于对照组,且DN组显著低于DM组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,DN患者血清NGAL、IL-27水平与尿MAU水平、24 h尿蛋白定量均呈正相关(P<0.05)。ROC曲线分析结果显示,尿MAU、血清NGAL、IL-27诊断DN的曲线下面积(AUC)分别为0.837、0.842、0.847,三者联合诊断DN的AUC为0.940,高于尿MAU、血清NGAL、IL-27单独诊断DN的AUC(Z=2.127、2.091、2.017,P=0.033、0.037、0.044)。结论 DN患者尿MAU、血清NGAL及IL-27水平均较高,且尿MAU联合血清NGAL、IL-27诊断DN的价值高于各指标单独检测,三者联合检测可在一定程度减少漏诊率,为DN患者的诊断提供参考价值,缩短DN患者康复进程。Objective To explore the application value of urinary microalbumin(MAU)combined with serum neutrophil gelatinase-associated lipocalin(NGAL)and interleukin-27(IL-27)in the diagnosis of diabetes nephropathy(DN).Methods From February 2021 to March 2022,50 patients with diabetes mellitus(DM)who admitted to the hospital were selected as the DM group and 55 patients with diabetic nephropathy(DN)as the DN group,while 60 age-matched healthy people who took medical examination in the hospital during the same period were selected as the control group.The serum NGAL,IL-27,hemoglobin,serum albumin,serum cystatin C,urinary MAU,urinary creatinine levels and 24 h urinary protein quantity in the three groups were detected.Pearson′s correlation was used to analyze the correlation between serum NGAL and IL-27 levels and urinary MAU level and 24 h urinary protein quantity in DN patients;the receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of urinary MAU,serum NGAL and IL-27 alone and in combination for the diagnosis of DN.Results The levels of serum cystatin C,urinary creatinine,urinary MAU,serum NGAL,IL-27 levels,urinary MAU/urinary creatinine ratio and 24 h urinary protein quantity in the DM group and DN group were significantly higher than those in the control group,which in the DN group were higher than those in the DM group,and the differences had staistically significant differences(P<0.05).The levels of hemoglobin,serum albumin in the DM group and DN group were lower than those in the control group,which in the DN group were lower than those in the DM group,with statistically significant differences(P<0.05).The results of Pearson correlation analysis showed that the levels of serum NGAL and IL-27 in DN patients were positively correlated with urinary MAU and 24 h urinary protein quantity(P<0.05).ROC curve analysis results showed that the area under the curve(AUC)of urinary MAU,serum NGAL and IL-27 in diagnosing DN were 0.837,0.842 and 0.847,respectively,and the AUC of the combined det

关 键 词：糖尿病肾病 尿微量清蛋白 中性粒细胞明胶酶相关脂质运载蛋白 白细胞介素-27 诊断价值 

分 类 号：R446.1[医药卫生—诊断学] R563.1[医药卫生—临床医学]