ROC曲线分析四种尿微量蛋白对糖尿病早期肾病的诊断价值

ROC curve evaluation of the diagnostic value of four kinds of Microalbuminuria for early diabetic nephropathy

目的探讨联合检测尿微量蛋白对早期糖尿病肾病(DN)的诊断价值。方法采用免疫比浊法检测59例尿蛋白阴性的糖尿病(DM)患者及39例健康对照者的尿m ALB、β2-MG、Ig G、TRF的含量,应用受试者工作特征曲线(ROC)分析上述指标诊断早期DN的价值。结果 DM组患者尿m ALB、TRF、Ig G及β2-MG水平均显著高于对照组,且差异有统计学意义(P<0.05);以尿m ALB、TRF、Ig G及β2-MG为参考,诊断早期糖尿病的敏感性分布为92.0%、82.4%、88.6%和78.1%。特异性分别为94.5%、76.9%、84.2%和0.84%。诊断的ROC曲线下面积分别为0.99、0.90、0.95和0.84。结论尿m ALB、β2-MG、Ig G、TRF可作为DN早期诊断的灵敏指标,其敏感性和特异性均较高。

Objective To explore the combined detection of urine micro protein value to the diagnosis of early diabetic nephropathy（DN）. MethodsThe immune turbidimetry, detection of 59 cases of urinary protein qualitative negative DM patients and 39 cases of healthy controls of urinary m ALB、β2-MG、Ig G、TRF agency. Results In group DM, the levels of m ALB, TRF, Ig G andβ2-MG in urine were significantly higher than those in the control group, and the difference was statistically significant（P 〈 0.05）. Urine m ALB, TRF, Ig G andβ2-MG were used as reference to diagnose the early diabetes, and the distribution of sensibility was 92%, 82.4%, 88.6% and 78.1% respectively. The specificity was 94.5%, 76.9%, 84.2% and 0.84%, respectively. The area of the diagnostic ROC curve was 0.99, 0.90, 0.95 and 0.84, respectively. Conclusion Urine m ALB, β2-MG, Ig G and TRF can be used as sensitive indexes for early diagnosis of DN, and their sensitivity and specificity are high.