尿白蛋白肌酐比与尿IgG联合检测在2型糖尿病肾病早期诊断中的研究分析  

Study analysis of urine albumin-creatinine ratio combined with urine IgG detection in early diagnosis of type 2 diabetic nephropathy

作　　者：赖宝瑶 周子琼 林铭健 LAI Baoyao;ZHOU Ziqiong;LIN Mingjian(Department of Laboratory Medicine,Yangjiang Hospital of Traditional Chinese Medicine,Guangdong Province,Yangjiang 529500,China)

机构地区：[1]广东省阳江市中医医院检验科,广东阳江529500

出　　处：《中国当代医药》2025年第4期120-123,共4页China Modern Medicine

基　　金：广东省阳江市医疗卫生类科技计划项目(SF2022018)。

摘　　要：目的探讨尿白蛋白肌酐比和尿IgG对2型糖尿病肾病的早期诊断价值。方法选取2022年8月至2024年1月150例2型糖尿病患者作为研究对象,根据24 h尿白蛋白排泄率(UAER)将其分为单纯糖尿病组、微量蛋白尿组和大量蛋白尿组,每组各50例。比较三组患者各项临床资料、尿肌酐、尿微量白蛋白、尿白蛋白与肌酐比值及尿IgG水平,并通过ROC曲线分析其诊断价值。结果微量蛋白尿组和大量蛋白尿组的尿肌酐低于单纯糖尿病组,且大量蛋白尿组尿肌酐低于微量蛋白尿组,差异有统计学意义(P<0.05);微量蛋白尿组和大量蛋白尿组尿微量白蛋白、尿白蛋白与肌酐比值、尿IgG高于单纯糖尿病组,且大量蛋白尿组尿微量白蛋白、尿白蛋白与肌酐比值、尿IgG高于微量蛋白尿组,差异有统计学意义(P<0.05)。ROC曲线结果显示,尿白蛋白与肌酐比值、尿IgG及平行试验对早期糖尿病肾病诊断的AUC值分别为0.741、0.736、0.872,尿白蛋白与肌酐比值、尿IgG及平行试验对早期糖尿病肾病大量蛋白尿诊断的AUC值分别0.809、0.848、0.952,二者联合诊断的诊断价值均高于单独诊断。结论尿白蛋白肌酐比与尿IgG对糖尿病患者的早期糖尿病肾病及大量蛋白尿具有较高的诊断价值,具有较高的临床应用潜力。Objective To investigate the value of urinary albumin-creatinine ratio and urinary IgG in the early diagnosis of type 2 diabetic nephropathy.Methods A total of 150 patients with type 2 diabetes mellitus from August 2022 to January 2024 were selected as the study subjects.According to 24 h urinary albumin excretion rate(UAER),they were divided into simple diabetes group,microalbuminuria group and macroalbuminuria group,with 50 cases in each group.The clinical data,urinary creatinine,urinary microalbumin,urinary albumin-to-creatinine ratio and urinary IgG level of the three groups were compared,and the diagnostic value was analyzed by ROC curve.Results The urinary creatinine of microproteinuria group and macroproteinuria group were lower than those of simple diabetes group,and the urinary creatinine of macroproteinuria group was lower than that of microproteinuria group,the differences were statistically significant(P<0.05).Urinary microalbumin,urinary albumin-to-creatinine ratio and urinary IgG in microalbuminuria group and macroalbuminuria group were higher than those in simple diabetes group,and microalbumin,urinary albumin-to-creatinine ratio and urinary IgG in macroalbuminuria group were higher than those in microalbuminuria group,the differences were statistically significant(P<0.05).ROC curve results showed that the AUC values of urinary albumin-to-creatinine ratio,urinary IgG and parallel test for early diagnosis of diabetic nephropathy were 0.741,0.736 and 0.872,respectively.The AUC values of urinary albumin-to-creatinine ratio,urinary IgG and parallel test were 0.809,0.848 and 0.952,respectively.The value of combined diagnosis was higher than that of single diagnosis.Conclusion Urinary albumin-creatinine ratio and urinary IgG have high diagnostic value for early diabetic nephropathy and massive proteinuria in diabetic patients,and have high clinical application potential.

关 键 词：尿微量白蛋白 24 h尿白蛋白排泄率 尿白蛋白与肌酐比值 2型糖尿病 糖尿病肾病 IgG 诊断价值 

分 类 号：R587[医药卫生—内分泌]