血清β2-MG、SCy-C联合ACR检测在慢性肾脏病中的应用价值  

Application value of combined detection of serumβ2-MG,SCy-C and ACR in chronic kidney disease

作　　者：丁亚红 邵云侠 杨婷婷[1] 姜姣姣 王羽 DING Yahong;SHAO Yunxia;YANG Tingting;JIANG Jiaojiao;WANG Yu(Department of Nephrology,Wuhu Hospital Affiliated to East China Normal University,Wuhu,Anhui 241000,China;Department of Nephrology,the Second Affiliated Hospital of Southern Anhui Medical College,Wuhu,Anhui 241000,China)

机构地区：[1]华东师范大学附属芜湖医院肾脏内科,安徽芜湖241000 [2]皖南医学院第二附属医院肾脏内科,安徽芜湖241000

出　　处：《检验医学与临床》2025年第6期810-814,共5页Laboratory Medicine and Clinic

基　　金：安徽省芜湖市科技计划项目(2022jc74)。

摘　　要：目的探讨血清β_(2)-微球蛋白(β_(2)-MG)、半胱氨酸蛋白酶抑制剂C(SCy-C)联合尿清蛋白/肌酐比值(ACR)检测在慢性肾脏病(CKD)中的应用价值。方法选取2022年1月至2024年1月在华东师范大学附属芜湖医院接受治疗的150例CKD患者作为试验组,另选取同期在华东师范大学附属芜湖医院进行体检的64例健康志愿者作为对照组。对比2组血清β_(2)-MG、SCy-C水平及ACR。按照GFR将CKD患者分为CKD1期组(GFR≥90 mL/min)30例、CKD2期组(60 mL/min≤GFR<90 mL/min)30例、CKD3期组(30 mL/min≤GFR<60 mL/min)30例、CKD4期组(15 mL/min≤GFR<30 mL/min)30例和CKD5期组(GFR<15 mL/min)30例。采用Spearman相关分析CKD患者血清SCy-C、β_(2)-MG水平及ACR与CKD分期的相关性;绘制受试者工作特征(ROC)曲线评估血清β_(2)-MG、SCy-C、ACR诊断CKD的价值。结果试验组血清β_(2)-MG、SCy-C水平及ACR高于对照组,差异均有统计学意义(P<0.05)。血清β_(2)-MG、SCy-C水平及ACR在CKD5期组>CKD4期组>CKD3期组>CKD2期组>CKD1期组,且两两比较,差异均有统计学意义(P<0.05)。Spearman相关分析结果显示,CKD患者血清SCy-C、β_(2)-MG水平及ACR与CKD分期均呈正相关(r=0.411,P<0.001;r=0.508,P<0.001;r=0.637,P<0.001)。ROC曲线分析结果显示,血清β_(2)-MG、SCy-C、ACR单独诊断CKD的曲线下面积(AUC)分别为0.628、0.666、0.786,3项指标联合诊断CKD的AUC为0.901,明显大于各指标单独检测的AUC(P<0.05)。结论CKD患者血清β_(2)-MG、SCy-C水平及ACR均明显升高,可作为评估CKD患者早期肾损害的重要指标,联合检测可有效提高早期诊断肾损害的效能,可为临床诊治提供参考依据。Objective To explore the application value of combined detection of serumβ_(2)-microglobulin(β_(2)-MG),cysteine protease inhibitor C(SCy-C)and urinary albumin/creatinine ratio(ACR)in chronic kidney disease(CKD).Methods A total of 150 CKD patients who were treated in Wuhu Hospital Affiliated to East China Normal University from January 2022 to January 2024 were retrospectively selected as the experimental group,and 64 healthy volunteers who underwent physical examination in Wuhu Hospital Affiliated to East China Normal University during the same period were selected as the control group.The serumβ_(2)-MG,SCy-C levels and ACR were compared between the two groups.According to the glomerular filtration rate(GFR),CKD patients were divided into CKD stage 1 group(GFR≥90 mL/min)with 30 cases,CKD stage 2 group(60 mL/min≤GFR<90 mL/min)with 30 cases,CKD stage 3 group(30 mL/min≤GFR<60 mL/min)with 30 cases,CKD stage 4 group(15 mL/min≤GFR<30 mL/min)with 30 cases and CKD stage 5 group(GFR<15 mL/min)with 30 cases.Spearman correlation was used to analyze the correlation of serum SCy-C,β_(2)-MG levels,ACR with CKD stage in CKD patients;receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of serumβ_(2)-MG,SCy-C and ACR for CKD.Results The serumβ_(2)-MG,SCy-C levels and ACR in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).The serumβ_(2)-MG,SCy-C levels and ACR in the CKD stage 5 group>the CKD stage 4 group>the CKD stage 3 group>the CKD stage 2 group>the CKD stage 1 group,and the differences were statistically significant in the pairwise comparison(P<0.05).The Spearman correlation analysis results showed that the serum SCy-C,β_(2)-MG levels and ACR were positively correlated with the CKD stage in CKD patients(r=0.411,P<0.001;r=0.508,P<0.001;r=0.637,P<0.001).The ROC curve results showed that the areas under the curve(AUC)of serumβ_(2)-MG,SCy-C and ACR in diagnosing CKD alone were 0.628,0.666 and 0.786,resp

关 键 词：慢性肾脏病 Β2-微球蛋白 半胱氨酸蛋白酶抑制剂C 尿白蛋白/肌酐比值 分期 相关性 

分 类 号：R446.1[医药卫生—诊断学] R692[医药卫生—临床医学]