摘要
目的:探讨血清、尿肾损伤分子-1(Kim-1)检测在糖尿病肾病(diabetic nephropathy,DN)早期诊断及病情发展中的预测价值。同时寻找Kim-1与临床诊断指标尿白蛋白(U-mALB)、血肌酐(SCr)及血清胱抑素C(CysC)之间的相关性。方法:选取我院内分泌科住院的2型糖尿病(type 2diabetes mellitus,T2DM)患者186例,根据尿清蛋白排泄率(UAER)分为3组:正常清蛋白尿组或单纯糖尿病组(NA组);微量清蛋白尿组(MI组);大量清蛋白尿组(MA组);53例健康体检者为正常对照组(NC组)。采用酶联免疫吸附法(ELISA)检测各组血清、尿标本中的Kim-1浓度;化学发光法检测U-mALB;以及乳胶增强免疫比浊法检测血清CysC水平,并且分析不同组Kim-1水平与不同临床检测指标间的相关性。结果:NA、MI、MA组血清、尿Kim-1水平与NC组比较均显著升高,差异有统计学意义(P<0.05),但NA组尿Kim-1水平与MI组相比无显著性差异(P>0.05);同时,MA组血清Kim-1与SCr呈正相关(R^2=0.1472,P<0.05)。NA、MI及MA组UAER、FPG、HbAic、U-mALB及血清CysC浓度较NC组明显升高(P<0.01)。NA组BUN、SCr与NC组比较差异无统计学意义(P>0.05),MI、MA组与NC组比较BUN、SCr增高(P<0.01)。结论:血清、尿Kim-1随UAER增加而升高,并且DN早期血清中Kim-1浓度就呈现明显的升高,是DN早期诊断的敏感指标,有望用于临床监测。
Objective：To investigate the diagnostic and predictive value of measuring of serum and urine kidney injury molecule 1（Kim-1）in patients with diabetic nephropathy.Methods：A total of 186 patients with type 2diabetes mellitus（T2DM）from our hospital were divided into normal albuminuria group（group NA）,micro-albuminuria group（group MI）,macroalbuminuria group（group MA）according to urine albumin excretion rate（UAER）.Fiftythree health subjects were enrolled as normal control group（group NC）.The serum and urine levels of Kim-1were detected by ELISA,the level of U-mALB was detected by chemiluminescence method,and the serum CysC was detected by emulsion reinforced immunoturbidimetry.Results：The serum and urine level of Kim-1in group NA,MI,MA was significantly higher than that in group NC（P〈0.05）.However,there was no significant difference of urine Kim-1between group NA and group MI（P〉0.05）.In addition,the serum level of Kim-1in group MA was positively correlated with the serum level of SCr（R2=0.1472,P〈0.05）.Compared with group NC,UAER,FPG,HbAic,U-mALB and CysC in group NA,MI and MA were obviously increased（P〈0.01）.BUN,SCr in group NA were no signigicant difference compared with NC（P〉0.05）,MI and MA groups were obviously increased（P〈0.01）.Conclusion：Serum and urine Kim-1increased according to excretion of UAER;especially serum Kim-1was obviously elevated in early renal damage,which can be used as a sensitive indicator of early renal damage in DN,and will have great significance for early diagnosis and surveillance of DN.
作者
陈玉姣
黄炎
CHEN Yujiao HUANG Yan(The People＇s Hospital of Longhua New District of Shenzhen, Shenzhen 518000, China)
出处
《西北国防医学杂志》
CAS
2017年第4期227-231,共5页
Medical Journal of National Defending Forces in Northwest China
