血清抗中性粒细胞胞浆抗体及相关炎性因子检测对糖尿病肾病的诊断价值

Diagnostic Value of Detection Anti-Cardiolipin Antibodies and Related Inflammatory Factors in Diabetic Nephropathy

目的探讨血清抗中性粒细胞胞浆抗体(ACA)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及超敏C-反应蛋白(hs-CRP)的检测对糖尿病肾病(DN)的诊断价值。方法选择2型糖尿病患者176例,依据尿微量清蛋白排泄率(UACR)分为单纯糖尿病组(DM组)、早期糖尿病肾病组(EDN组)和临床糖尿病肾病组(CN组),同时选取健康体检者60例作为对照组(NC组)。采用间接酶联免疫法检测ACA,免疫比浊法分析血清NGAL和hs-CRP水平。结果与NC组比较,DM组NGAL,hs-CRP及ACA-IgM水平升高,差异有统计学意义(P<0.05或P<0.01);EDN组NGAL,hs-CRP,ACA-IgG和ACA-IgA水平升高,差异均有统计学意义(P<0.05或P<0.01);CN组NGAL,hs-CRP,ACA-IgG和ACAIgA水平升高,差异有统计学意义(P<0.05或P<0.01);与DM组比较,EDN组NGAL和hs-CRP水平升高,差异有统计学意义(P<0.05),CN组NGAL,hs-CRP和ACA-IgA水平升高,差异有统计学意义(P<0.05或P<0.01);与EDN组比较,CN组NGAL和hs-CRP水平升高,差异有统计学意义(P<0.01)。NGAL,hs-CRP及ACA-IgA分别与ACR呈正相关(r=0.510,0.366,0.206,均P<0.01)。结论血清NGAL,hs-CRP和ACA-IgM可提示早期肾损害,NGAL,hs-CRP及ACA可作为DN病情进展过程中的监测指标。

Objective To investigate the diagnostic value of serum neutrophil gelatinase-associated lipocalin（NGAL）, hypersensitive C-reactive protien（hs-CRP） and anti-cardiolipin antibodies（ACA） in diabetic nephropathy （DN）. Methods 176 pa- tients with type 2 diabetes mellitus （T2DM）were divided into three groups according to anurinary albumin to creatinine ratio （ACR） ..diabetic mellitus group （DM group） , early diabetic nephropathy group （EDN group） and clinic diabetic nephropathy group （CN group）. 60 healthy subjects in the same period determined by physical examination were enrolled as the control group （NC group）. Analyzed ACA levels among 4 groups by indirect immunoIluorescence, while NGAL and hs-CRP were measured by immunoturbidimetry. Results Compared with NC group, NGAL, hs-CRP and anti-cardiolipin antibodies im- mune globulin M （ACA-IgM）levels in DM group were increased, and levels of NGAL, hs-CRP, anti-cardiolipin antibodies immune globulin G （ACA-IgG）and anti-cardiolipin antibodies immune globulin A （ACA-IgA） in EDN group and CN group were higher than those in NC group, the differences had statistical significance （p〈0.05 or p〈0.01）. Compared with DM group, levels of NGAL and hs-CRP in EDN group were increased, while levels of NGAL, hs-CRP and ACA-IgA in CN group were also increased, the differences had statistical significance （p〈0.05 or p〈0.01）, and CN group compared with EDN group, NGAL and hs-CRP levels were increased,the differences had statistical significance （p〈0.01）. ACR was negatively correlated with NGAL, hs-CRP and ACA-IgA （ r= 0. 510,0. 366,0. 206, p〈0.01）. Conclusion Levels of NGAL, hs-CRP and ACA-IgM can remind early renal damage, while levels of NGAL, hs-CRP and ACA can monitor the progress of DN.