脂蛋白（a）在糖尿病肾病早期诊断中的价值

The early diagnostic value of lipoprotein （a）for diabetic nephropathy

目的 探讨Lp（a）在糖尿病肾病（DN）早期诊断中的意义.方法 收集2016年1月1日至2017年1月31日期间北京清华大学第一附属医院确诊的糖尿病患者228名,根据UAER分为无肾病组131例、低量组47例和高量组50例,选取同期健康体检者30名,检测各待测者血清中的Lp（a）及其他血脂水平,评估Lp（a）对糖尿病肾病早期诊断的价值.结果 Lp（a）在糖尿病无肾病患者中未发生明显升高（P〉0.05）,但是无论低排量组还是高排量组的患者Lp（a）均发生升高,差异均有统计学意义（P〈0.05）.Lp（a）与UAER有良好的相关性（r=0.449,P〈0.05）.ROC曲线显示Lp（a）诊断糖尿病肾病的临界值为75.1 nmol/L,敏感度和特异度分别为61.9% 和68.0%.结论 Lp（a）可作为糖尿病肾病早期诊断的辅助指标,其水平高低在一定程度上可反映肾脏损伤程度.

Objective To explore the early diagnostic value of lipoprotein （a）for diabetic nephropathy.Methods Serum serum Lp（a）and other lipid levels sere detected in 131 non DN patients,47 low dose patients,51 high dose patients with diabetes diag-nosed according to UAER and 30 healthy persons,which were collected from January 1,2016 to January 31,2017.Results There was no significant difference in the levels of Lp（a）in non DN group（P〉0.05）.However,the levels of Lp（a）in both low and high dose groups were significantly increased,and the difference was statistically significant （P〈0.05）.The levels of Lp（a）had good correlation with UAER （r=0.449,P〈0.05）.The boundary value of diagnosis of diabetic nephropathy through Lp（a）identified through ROC curve was 75.1nmol/L.The sensitivity and specificity of the Lp（a）for the diagnosis of diabetic nephropathy were re-spectively 61.9% and 68.0%.Conclusion Lp （a）can be used as an auxiliary index for early diagnosis of diabetic nephropathy,and its level can reflect the degree of renal injury to some extent.