血清视黄醇结合蛋白及中性粒细胞明胶酶相关载脂蛋白在糖尿病肾病中的临床价值研究

Clinical value of serum retinol binding protein and neutrophil gelatinase associated apolipoprotein in diabetic nephropathy

目的血清视黄醇结合蛋白(RBP)及中性粒细胞明胶酶相关载脂蛋白(NGAL)在糖尿病肾病(DN)诊治中的临床应用价值研究。方法 148例2型糖尿病患者,依据尿白蛋白肌酐比值(ACR)结果分成正常蛋白尿组、早期糖尿病肾病组和临床肾病组,同期50例健康体检者为对照组。常规进行RBP、NGAL、胱抑素(Cys-C)、血肌酐、尿素氮和β2-微球蛋白检测。结果早期糖尿病肾病组及临床肾病组BUN、Cr、Cys-C、β2-MG、RBP、NGAL水平及阳性率显著高于正常蛋白尿及对照组,差异有统计学意义(P<0.05)。RBP、NGAL的阳性率显著高于其他指标,差异有统计学意义(P<0.05)。用于DN的早期诊断,RBP特异度显著优于NGAL及ACR,差异有统计学意义(P<0.05)。DN患者RBP水平与NGAL、ACR呈显著正相关(P<0.01)。结论早期糖尿病肾病及临床肾病患者血清RBP及NGAL明显升高,可能与疾病的发生发展密切相关。

Objective To investigate the clinical value of serum retinol binding protein（ RBP） and neutrophil gelatinase associated apolipoprotein（ NGAL） in the diagnosis and treatment of diabetic nephropathy（ DN）. Methods 148 cases of type 2 diabetes mellitus（ T2DM） were enrolled. These patients were classified into three groups according to their albumin/creatinine ratio（ ACR） ： normal proteinuria group,micro proteinuria group and clinical nephropathy group. Fifty healthy subjects undergoing healthy physical examination were selected as a control group. The RBP,NGAL,cystatin C,creatinine,BUN and β2-MG levels were detected. Results BUN,Cr,Cys-C,β2-MG,RBP,NGAL levels in micro proteinuria group and clinical nephropathy group and the positive rate were significantly higher than those in normal proteinuria group and control group（ P〈0. 05）. The positive rates of RBP and NGAL were significantly higher than other indexs（ P〈0. 05）. For the early diagnosis of DN,the RBP specificity was significantly better than that of NGAL and ACR（ P〈0. 05）. The level of RBP in patients with DN was significantly positively correlated with NGAL and ACR（ P〈0. 01）. Conclusion The serum levels of RBP and NGAL in patients withmicro proteinuria and clinical nephropathy were significantly increased,which might be closely related to the occurrence and development of the disease