血清β_2微球蛋白联合N末端脑钠肽前体在2型糖尿病肾病中的临床价值研究

The Clinical Value of Serum β_2-microglobulin Combined with N-terminal Pro-brain Natriuretic Peptide in Patients with Type 2 Diabetic Nephropathy

目的探究血清β_2微球蛋白(β_2-microglobulin,β_2-MG)联合N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)在2型糖尿病肾病中的诊断、风险评估价值,及二者与2型糖尿病肾病病理特征的关系。方法选取2013年2月至2017年10月在我院确诊的2型糖尿病肾病患者125例为观察组,与同期在我院确诊为糖尿病并排除并发症的患者130例为对照组。比较两组研究对象血清β_2-MG与NT-proBNP水平,分析二者与2型糖尿病肾病临床病理特征的关系,受试者工作特征曲线(receiver operating characteristic,ROC)分析二者在2型糖尿病肾病中的诊断价值,Logistic回归分析二者对2型糖尿病肾病的发病风险评估价值。结果观察组血清β_2-MG与NT-proBNP水平均显著高于对照组(P<0.05),且二者水平与2型糖尿病肾病临床分期明显相关(P<0.05)。ROC曲线分析显示,联合血清β_2-MG与NT-proBNP区分2型糖尿病肾病患者和无并发症糖尿病人群的曲线下面积(area under curve,AUC)为0.974(95%CI:0.902～0.991,P<0.001),灵敏度为86.8%,特异性为94.6%。多项Logistic回归分析表明,血清高β_2-MG与NT-proBNP水平是2型糖尿病肾病发病的独立危险因素(P<0.05)。结论血清β_2-MG与NT-proBNP可协助2型糖尿病肾病的诊断,同时,二者对2型糖尿病肾病发病风险的评估也具有潜在价值。

Objective To investigate the diagnostic and risk assessment values of serum β2-microglobulin （ β2- MG）combined with N-terminal pro-brain natriuretic peptide （NT-proBNP）in type 2 diabetic nephropathy patients and the relationships between these factors and pathological characteristics of type 2 diabetic nephropathy. Methods 125 patients with type 2 diabetic nephropathy diagnosed in our hospital from February 2013 to October 2017 were selected as the observation group, and 130 patients diagnosed as type 2 diabetes but excluded complications at the same period of time in our hospital were selected as the control group. The serum levels of β2-MG and NT-proBNP were compared between the two groups, and the relationships between these two factors and the clinicopathological features of type 2 diabetic nephropathy were analyzed. The diagnostic power was assessed by the Receiver Operating Characteristic（ ROC）, and the multiple logistic regression analysis was used to analyze the risk assessment value for the onset of diabetic nephropathy. Results The average levels of serum β2-MG and NT-proBNP in the observation group were significantly higher than that of the control group （ P 〈 0.05 ）, and the levels of the two were significantly correlated with the clinical stage of type 2 diabetic nephropathy （P 〈 0.05 ）. The ROC curve showed that the area under curve （AUC） for combination of serum β2-MG and NT-proBNP was 0. 974（95% CI：0. 902 - 0. 991 ,P 〈0. 001 ） to distinguish patients with type 2 diabetic nephropathy from non-complication diabetes, with a sensitivity of 86.8% and a specificity of 94.6%. Logistic regression analysis showed that high levels of serum β2-MG and NT-proBNP were independent risk factors for type 2 diabetic nephropathy（ P 〈 0.05 ）. Conclusion Serum β2-MG and NT-proBNP can assist in the diagnosis of type 2 diabetic nephropathy, with the potential value for the risk assessment for type 2 diabetic nephropathy.