糖化血红蛋白联合尿微量白蛋白/尿肌酐比值对早期糖尿病肾病的预测价值探讨  

Exploring the Predictive Value of Glycated Haemoglobin Combined with Urinary ACR in Early Diabetic Nephropathy

作　　者：王晨 杨晨 石惠茹 WANG Chen;YANG Chen;SHI Huiru(Department of Endocrinology,Tianjin Huanghe Hospital,Tianjin 300110,China)

机构地区：[1]天津市黄河医院内分泌科,天津300110

出　　处：《糖尿病新世界》2024年第13期27-30,共4页Diabetes New World

摘　　要：目的探讨早期糖尿病肾病(diabetic nephropathy,DN)患者应用尿微量白蛋白/尿肌酐比值(albumin-to-creatinine ratio,ACR)联合糖化血红蛋白(glycated hemoglobin A1c,HbA1c)的预测价值。方法回顾性选取天津市黄河医院于2022年3月—2024年3月收治的115例2型糖尿病患者的临床资料,根据是否发生肾病分为两组,其中早期DN患者为DN组(36例),单纯糖尿病患者为糖尿病组(79例)。分析两组患者基本资料及外周血HbA1c、空腹血糖、餐后2 h血糖水平与尿ACR水平,早期DN患者的危险因素采用多因素Logistic回归分析筛选,分析早期DN患者应用尿ACR、外周血HbA1c单一及联合检测的诊断价值。结果DN组尿ACR、外周血HbA1c水平高于糖尿病组,差异有统计学意义(P均<0.05)。多因素Logistic回归分析显示,尿ACR≥30μg/mg、外周血HbA1c≥6%为早期DN患者的独立危险因素(P均<0.05)。尿ACR、外周血HbA1c联合检测的AUC高于外周血HbA1c、尿ACR单一检测。结论早期DN患者应用ACR、HbA1c联合检测的诊断价值较高,可用于临床诊断。Objective To investigate the predictive value of urinary albumin-to-creatinine ratio(ACR)combined with glycated hemoglobin A1c(HbA1c)in patients with early diabetic nephropathy(DN).Methods The clinical data of 115 patients with type 2 diabetes mellitus admitted to Tianjin Huanghe Hospital from March 2022 to March 2024 were ret⁃rospectively selected.According to the occurrence of nephropathy,they were divided into two groups,including early DN patients as DN group(36 cases)and simple diabetes patients as diabetes group(79 cases).The basic data of the two groups of patients and the ratio of peripheral blood HbA1c,fasting blood glucose,2-hour postprandial blood glu⁃cose and urinary ACR levels were analyzed.The risk factors of early DN patients were screened by multivariate Logis⁃tic regression analysis.The diagnostic value of single and combined detection of urinary ACR and peripheral blood HbA1c in patients with early DN was analyzed.Results The urinary ACR and peripheral blood HbA1c level in the DN group were higher than those in the diabetic group,and the differences were statistically significant(both P<0.05).Multivariate Logistic regression analysis showed that high levels of urinary ACR≥30μg/mg and peripheral blood HbA1c≥6%were independent risk factors for early DN patients(both P<0.05).The AUC of combined detection of uri⁃nary ACR and peripheral blood HbA1c was higher than that of single detection of peripheral blood HbA1c and urinary ACR.Conclusion The diagnostic value of combined detection of ACR and HbA1 c in patients with early DN is high,which can be used for clinical diagnosis.

关 键 词：糖尿病肾病 糖化血红蛋白 尿微量白蛋白/尿肌酐比值 诊断价值 

分 类 号：R587.1[医药卫生—内分泌]