摘要
目的探讨血清视黄醇结合蛋白(RBP)、尿肾损伤因子-1(KIM-1)及尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)在糖尿病肾病诊断及预后中的临床价值。方法选取2017年1月至2019年1月于该院收治的260例2型糖尿病患者作为研究对象,根据估算肾小球滤过率水平不同将其分为非糖尿病肾病组140例和糖尿病肾病组120例,再根据尿清蛋白/肌酐比值将糖尿病肾病组细分为正常蛋白尿组52例、微量蛋白尿组35例和大量蛋白尿组33例。采用免疫透射比浊法检测RBP;采用酶联免疫吸附试验检测尿KIM-1;采用比色法检测尿NAG。结果与非糖尿病肾病组比较,糖尿病肾病组血清RBP、尿KIM-1及尿NAG均明显升高,差异有统计学意义(P<0.05);绘制受试者工作特征曲线发现,血清RBP、尿KIM-1和尿NAG单项检测对糖尿病肾病均有一定诊断价值(P<0.05),而联合检测可提高其诊断效能,以血清RBP+尿KIM-1+尿NAG诊断效能最高,其灵敏度和特异度分别为92.5%和95.8%。正常蛋白尿组、微量蛋白尿组和大量蛋白尿组血清RBP、尿KIM-1及尿NAG依次升高,差异有统计学意义(P<0.05)。随访半年发现,120例糖尿病肾病患者中预后良好者90例,预后不良者30例;预后不良者血清RBP、尿KIM-1及尿NAG明显高于预后良好者,差异均有统计学意义(P<0.05)。以糖尿病肾病预后为因变量,以血清RBP、尿KIM-1及尿NAG为自变量进行非条件Logistic回归分析,分析得知血清RBP、尿KIM-1及尿NAG均为影响糖尿病肾病预后的危险因素(P<0.05)。结论血清RBP、尿KIM-1及尿NAG在糖尿病肾病中呈高表达,是判断糖尿病早期肾损伤的有效指标,也是影响糖尿病肾病预后的危险因素。
Objective To investigate the clinical significance of serum retinol binding protein(RBP),urine kidney injury factor-1(KIM-1)and urine N-acetyl-β-D glucosamindase(NAG)in the diagnosis and prognosis of diabetic nephropathy value.Methods A total of 260 patients with type 2 diabetes mellitus admitted to a hospital from January 2017 to January 2019 were enrolled in the study.They were divided into non-diabetic nephrotic group(n=140)and diabetic nephropathy group(n=120)according to eGFR levels,and then the diabetic nephropathy group was subdivided into normal proteinuria group according to urinary albumin/creatinine ratio(n=52),microalbuminuria(n=35)and a large amount of proteinuria(n=33).RBP was detected by immunity transmission turbidity,urine KIM-1 was detected by enzyme-linked immunosorbent assay,urine NAG was detected by colorimetry.Results Compared with non-diabetic nephropathy,serum RBP,urine KIM-1 and urine NAG were significantly increased in diabetic nephropathy,and the difference was statistically significant(P<0.05).ROC curve was drawn and serum RBP,urine KIM-1 and urine NAG were found.The detection had certain diagnostic value for diabetic nephropathy(P<0.05),and combined detection could improve its diagnostic efficiency.Serum RBP+urine KIM-1+urine NAG had the highest diagnostic efficiency,and its sensitivity and specificity were 92.5%and 95.8%,respectively.Serum RBP,urine KIM-1 and urine NAG increased in the normal proteinuria group,microalbuminuria group and large amount of proteinuria group,and the difference was statistically significant(P<0.05).During the follow-up of half a year,90 patients with diabetic nephropathy had a good prognosis and 30 patients with poor prognosis.Serum RBP,urine KIM-1 and urine NAG were significantly higher than those with good prognosis.The difference was statistically significant(P<0.05).Taking the prognosis of diabetic nephropathy as the dependent variable,serum RBP,urine KIM-1 and urine NAG as independent variables for unconditional logistic regression analysis,analysis of serum RBP,urine KIM-1 and urine NAG were all affecting the prognosis of diabetic nephropathy risk factors(P<0.05).Conclusion Serum RBP,urine KIM-1 and urine NAG are highly expressed in diabetic nephropathy,which is an effective index for judging early diabetic nephropathy and a risk factor for the prognosis of diabetic nephropathy.
作者
黄裕林
黎妮
HUANG Yulin;LI Ni(Department of Clinical Laboratory,Kaizhou District People′s Hospital,Chongqing 405400,China)
出处
《检验医学与临床》
CAS
2021年第12期1701-1704,共4页
Laboratory Medicine and Clinic
