血清N末端脑利钠肽前体水平对2型糖尿病肾病的诊断价值

The value of serum NT pro-BNP level in the diagnosis of kidney disease in patients with type 2 diabetes mellitus

目的:探讨血清N末端脑利钠肽前体(NT-proBNP)水平对2型糖尿病(T2DM)肾病的诊断价值。方法:选取2015年12月至2017年6月在淮南市第一人民医院内分泌科接受治疗的100例T2DM患者作为研究对象,分为T2DM组(n=58,24h尿微量白蛋白<30mg)和糖尿病肾病(DKD)组(n=42,24h尿微量白蛋白≥30mg),另选取同期在本院行健康体检的50例健康志愿者作为对照组。采用酶联免疫吸附试验(ELISA)法检测血清NT-proBNP水平,分析血清NT-proBNP水平与相关临床指标的关系,应用受试者工作特征(ROC)曲线评估血清NT-proBNP对DKD的诊断价值。结果:T2DM组和DKD组患者血清NT-proBNP水平均较对照组明显升高(P<0.05),且DKD组患者血清NT-proBNP水平高于T2DM组(P<0.05)。Pearson相关分析显示,血清NT-proBNP水平与糖尿病病程、糖化血红蛋白(HbA1c)、尿白蛋白排泄率(UAER)、低密度脂蛋白(LDL)、血肌酐(SCr)呈正相关关系(P<0.05),与预估肾小球滤过率(eGFR)、高密度脂蛋白(HDL)呈负相关关系(P<0.05)。ROC曲线显示,NT-proBNP预测DKD的曲线下面积为0.794(95%CI:0.744~0.844,P<0.01)。结论:血清NTproBNP水平在DKD患者中显著升高,可能成为早期诊断DKD的新的生物学标志物。

Objective：To investigate the role of serum N-terminal pro brain natriuretic peptide（NT-proBNP）level in patients with type 2 diabetic kidney disease（DKD）.Methods：100 patients with type 2 diabetes mellitus（T2 DM）in our hospital from December 2015 to June 2017 were selected,and assigned into T2 DM group（n=58,microalbuminuria30 mg/24 h）and DKD group（n=42,microalbuminuria≥30 mg/24 h）.50 healthy volunteers were enrolled as controls.The serum NT-proBNP level was detected by enzyme linked immunosorbent assay（ELISA）.The correlation between serum NT-proBNP level and relevant clinical indicators was analyzed.The diagnostic value of serum NT-proBNP level for DKD was assessed by receiver operating characteristic（ROC）curve.Results：The serum NT-proBNP level in T2 DM and DKD groups was significantly higher than that in the control group（P〈0.05）,and was higher in the DKD group（P〈0.05）.Pearson correlation analysis revealed that serum NT-proBNP level was positively associated with the course of diabetes,urine albumin excretion rate（UAER）,hemoglobin A1 c（HbA1 c）,low density lipoprotein（LDL）and serum creatinine（SCr）level（P〈0.05）,while was negatively correlated with estimated glomerular filtration rate（eGFR）and high density lipoprotein（HDL）level（P〈0.05）.The area under the ROC of NTproBNP in predicting DKD was 0.794（95%CI：0.744-0.844,P〈0.01）.Conclusion：The serum NT-proBNP level was significantly elevated in DKD patients,which might be a novel biological marker in early diagnosis of DKD.