联合检测标志物在糖尿病肾病早期肾损伤诊断中的临床价值

Clinical value of combined detection of mALB,UCr,alpha -MG,beta 2-MG and NAG in diagnosis of early renal injury in diabetic nephropathy

目的探讨mALB、UCr、α-MG、β2-MG、NAG联合检测在糖尿病肾病早期肾损伤诊断中的临床价值。方法随机选取2016年6月～2018年6月在我院治疗的500例糖尿病肾病患者作为研究组,并选取500例在我院体检的健康人作为对照组,测定两组尿液中的mALB、UCr、α-MG、β2-MG、NAG的含量,并对两组结果进行比较。结果研究组UCr/Cr、MALB/Cr、β2-MG/Cr、NAG/C比值与对照组比较差异有统计学意义(P<0.05);使用mALB、UCr、β2-MG、NAG单项指标的阳性率要明显低于采用mALB+UCr和β2-MG+NAG两项指标双向检验的阳性率(P<0.05);采用mALB+UCr+β2-MG+NAG+α-MG五项指标联合检验的阳性率要明显高于使用mALB、UCr、β2-MG、NAG单项指标的阳性率和采用mALB+UCr和β2-MG+NAG两项指标双向检验的阳性率(P<0.05);采用mALB+UCr+β2-MG+NAG+α-MG五项指标联合检验的阳性率要明显高于采用血清肌酐该种指标的阳性率(P<0.05);采用mALB+UCr+β2-MG+NAG+α-MG五项指标联合检验的阳性率要明显高于采用尿素氮该种指标的阳性率(P<0.05);采用mALB+UCr+β2-MG+NAG+α-MG五项指标联合检验的阳性率要明显高于采用内生肌酐该种指标的阳性率(P<0.05)。结论 mALB、UCr、α-MG、β2-MG、NAG联合检测可以灵敏地测得糖尿病肾病患者的身体变化,使患者可以尽早得到治疗,肾小管的损伤比肾小球的损伤出现的时间要早,值得临床借鉴。

Objective To explore the clinical value of combined detection of mALB,UCr,α-MG,β2-MG,and NAG in the early diagnosis of renal injury in diabetic nephropathy.METHODS 500 patients with diabetic nephropathy who were treated in our hospital from June 2016 to June 2018 were randomly selected as the study group and 500 healthy people examined in our hospital were selected as the control group.The urine in the two groups was measured.The contents of mALB,UCr,α-MG,β2-MG,and NAG were compared between the two groups.Results The ratios of UCr/Cr,MALB/Cr,β2 MG/Cr,and NAG/C in the study group were significantly higher than those in the control group（P〈0.05）.The individual indicators of mALB,UCr,β2-MG,and NAG were used.The positive rate was significantly lower than that of the two-way test using mALB＋UCr andβ2-MG＋NAG（P〈0.05）,and the combined test of mALB＋UCr＋β2-MG＋NAG＋α-MG was used.The positive rate was significantly higher than the positive rate of the mALB,UCr,β2-MG,NAG single index and the positive rate of the two-way test of mALB＋UCr and β2-MG＋NAG（P〈0.05）.The mALB＋ was used.The positive rate of UCr＋β2-MG＋NAG＋α-MG combined test was significantly higher than that of serum creatinine（P〈0.05）.mALB＋UCr＋β2-MG＋NAG＋α-MG was used.The positive rate of the combined test of the MG five indicators was significantly higher than that of the urea nitrogen（P〈0.05）,and the combined test of the five indicators of mALB＋UCr＋β2-MG＋NAG＋α-MG was positive.The rate was significantly higher than that of endogenous creatinine（P〈0.05）.Conclusion Combined detection of mALB,UCr,α-MG,β2-MG,and NAG can sensitively measure the physical changes in patients with diabetic nephropathy,so that patients can be treated as soon as possible,and the damage of renal tubules is longer than that of glomerular injury.Early,it is worth further promotion and application in clinical practice.