血清NT-pro-BNP与Hcy联合检测对糖尿病肾病早期诊断价值

The value of combined detection of serum NT-pro-BNP and serum homocysteine(Hcy) in the early diagnosis of diabetic nephropathy

目的:观察联合检测血清NT-pro-BNP和血清同型半胱氨酸(Hcy)在糖尿病肾病早期诊断中的价值。方法:80例糖尿病患者根据UAER分为无蛋白尿组,微量蛋白尿组和临床蛋白尿组,30例健康体检者为对照组,采用酶联免疫荧光法检测血清NT-pro-BNP,循环液相法检测血清Hcy,比较各组NT-pro-BNP和Hcy含量,分析单项检测和联合检测的灵敏度和特异度,计算单项检测和联合检测ROC曲线下面积。结果:微量蛋白尿组和临床蛋白尿组血清NT-pro-BNP和Hcy含量明显高于健康对照组及无蛋白尿组差异均有统计学意义(P<0.05),NT-pro-BNP和Hcy联合检测的特异度为74.1%,敏感度为94.6%,明显高于单项指标检测的特异度和敏感度,联合NT-pro-BNP和Hcy检测ROC曲线下面积0.922,明显高于单项检测指标的曲线下面积。结论:血清NT-pro-BNP与同型半胱氨酸联合检测较单一检测诊断价值高,能提高糖尿病肾病早期肾损害的诊断效果,值得临床进一步推广。

Objective：To observe the value of combined detection of serum NT-pro-BNP and serum homocysteine （Hcy） in the early diagnosis of diabetic nephropathy. Methods： According to UAER, 80 diabetic patients were divided into the non-proteinuria group, the microalbuminuria group and the clinical albuminuria group. 30 healthy people were taken as control group. NT-pro-BNP and Hcy were detected by enzyme-linked immunofluorescence assay and circulating liquid chromatography respectively. NT-pro-BNP and Hcy in each group were detected and analyzed. Sensitivity and specificity were calculated for single detection and combined detection of the area under the ROC curve. Results： The levels of NT- pro-BNP and Hcy in serum of the microalbuminuria group and the clinical albuminuria group were significantly higher than those of the healthy control group and the non-albuminuria group （P〈0.05）. The specificity and sensitivity of combined detection of NT-pro-BNP and Hcy were /4.1% and 94.6% respectively, which were significantly higher than those of single index detection. The area of the ROC curve detected with NT-pro-BNP and Hcy was 0.922, which was significantly higher than the area of the ROC curve. Conclusion： The combined detection of serum NT-pro-BNP and homocysteine has higher diagnostic value than single detection, and can improve the diagnostic effect of early renal damage in diabetic nephropathy, which is worthy of further clinical application.