摘要
目的分析血清胱抑素C(Cys C)、血清β2-微球蛋白(β2-MG)与尿中肾脏损伤因子-1(kim-1)、尿微量清蛋白(M-ALB)联合检测在早期糖尿病肾(DN)病诊断中的应用价值。方法选择2017年1月至2018年3月到该院就诊的138例2型糖尿病患者为研究对象,根据患者24h尿微量清蛋白排泄率检查结果不同分为非糖尿病肾病组(NDN)和DN组,每组各69例;另于同期选择70例健康体检者为对照组,均进行血清Cys C、血清β2-MG、尿kim-1、尿M-ALB等项目检测,并分析3组检测结果的差异。结果 DN组、NDN组的血清Cys C、血清β2-MG、尿kim-1、尿M-ALB水平均显著高于对照组(P<0.05),且DN组的上述指标水平也高于NDN组(P<0.05);在DN组中,患者的血清Cys C、血清β2-MG、尿kim-1、尿M-ALB水平会随其病程的增加而升高,差异具统计学意义(P<0.05);血清Cys C、血清β2-MG、尿kim-1、尿M-ALB联合检测的灵敏度为91.30%、准确率为89.13%、阴性预测值为90.91%,均明显高于单独检测结果(P<0.05),但组间特异度比较差异无统计学意义(P>0.05)。结论与单独检测相比,血清Cys C、血清β2-MG与尿kim-1、尿M-ALB联合检测具有较高灵敏度,能够显著提高诊断准确率,可作为早期DN诊断的主要方法。
Objective To analyze the applied value of joint detection of serum Cystatin C,β2-microglobulin,kidney injury molecule 1 and micro-albuminuria in the early diabetic nephropathy diagnosis. Methods A total of 138 patients with type-2 diabetes were selected from our hospital from January 2017 to March 2018,and divided into non-diabetic nephropathy （NDN） group and diabetic nephropathy （DN） group according to the detection results of the patients′ 24 hours micro-albuminuria excretion rate.Each group had 69 patients.In the same period,70 healthy people were selected as the control group.Cystatin C,β2-microglobulin,kidney injury molecule 1 and micro-albuminuria were tested,and differences among the three groups were analyzed. Results The levels of serum Cystatin C,β2-microglobulin,kidney injury molecule 1 and micro-albuminuria in DN group and NDN group were all significantly higher than those in the control group （ P 〈0.05）,and the above index levels of the DN group were significantly higher than those in the NDN group （ P 〈0.05）.In the DN group,the levels of the patients′ serum Cystatin C,β2-microglobulin,kidney injury molecule 1 and micro-albuminuria increased with the course of the disease,and the differences had statistical significances （ P 〈0.05）.Sensitivity,accuracy and negative predictive value of joint detection of serum Cystatin C,β2-microglobulin,kidney injury molecule 1 and micro-albuminuria were 91.30%,89.13% and 90.91%,which were significantly higher than that of either single detection （ P 〈0.05）.While the specificities were not statistically different （ P 〉 0.05）. Conclusion Compared with single item detection,the joint detection of serum Cystatin C,β2-microglobulin,kidney injury molecule 1 and micro-albuminuria has higher sensitivity,which significantly improves the diagnosis accuracy and becomes the main method of early DN diagnosis.
作者
刘莉
张军
LIU Li;ZHANG Jun(Department of Clinical Laboratory,the 3201 Hospital Affiliated of Medical College of Xi′an JiaotongUniversity,Hanzhong,Shaanxi 723000,China）.)
出处
《检验医学与临床》
CAS
2018年第23期3515-3517,3520,共4页
Laboratory Medicine and Clinic
