血清胱抑素联合尿微量清蛋白、尿转铁蛋白、24h尿蛋白检测对早期糖尿病肾病的诊断价值

Effect of serum Cys-C level combined with UmAlb and UTRF on diagnosis of patients with early diabetic nephropathy

目的探讨血清胱抑素(Cys-C)水平联合尿微量清蛋白(UmAlb)、尿转铁蛋白(UTRF)、24h尿蛋白检测对早期糖尿病肾病(DN)的诊断价值。方法选取2016年9月至2017年12月西山煤电集团公司职工总医院糖尿病患者84例作为观察组,将其中伴有DN患者设为观察A组(n=42),单纯糖尿病患者设为观察B组(n=42),另抽取42例同期体检健康者作为对照组。分别采集三组血液及尿液样本,以乳胶颗粒增强免疫比浊法测定血清Cys-C,速率免疫散射比浊法测定UTRF,免疫透射比浊法测定UmAlb,邻苯三酚红比色法测定24h尿蛋白。比较各组血清Cys-C、UTRF、UmAlb、24h尿蛋白水平,并计算血清Cys-C、UTRF、UmAlb、24h尿蛋白单项或联合检测特异度、敏感度及准确性。结果观察B组血清Cys-C、UTRF、UmAlb、24h尿蛋白水平均高于对照组,且观察A组血清Cys-C、UTRF、UmAlb、24h尿蛋白水平均高于观察B组,差异均有统计学意义(P均<0.05);四项联合检测准确性高于血清Cys-C、UTRF、UmAlb、24h尿蛋白水平单项检测,敏感度高于UTRF,特异度高于血清Cys-C,差异有统计学意义(P<0.05)。结论血清Cys-C联合UTRF、UmAlb、24h尿蛋白水平检测早期DN,阳性检出率较高,可有效提高检测准确性,有助于控制病情进展,改善患者预后。

Objective To investigate the effect of serum cystatin(Cys-C)level combined with urinary microalbumin(UmAlb),urinary transferrin(UTRF)and 24 h urinary protein on the diagnosis of patients with early diabetic nephropathy(DN).Methods Eighty-four diabetic patients in Xishan Coal Electricity Group Worker General Hospital from September 2016 to December 2017 were selected as the observation group.The patients with DN were selected as observation group A(n=42)and simple diabetic patients were selected as observation group B(n=42),and 42 people who experienced physical examination at the same period were selected as control group.The blood and urine samples were extracted,the serum Cys-C was measured by latex granule-enhanced immunoturbidimetry,and the level of UTRF was measured by immuno-turbidimetric assay,and the level of urinary microalbumin(UmAlb)was detected by immuno turbidimetry.The level of 24 h urinary protein was detected by o-benzene three phenol red colorimetry.The serum Cys-C,urinary UTRF,UmAlb levels and 24 h urinary protein in the three groups were compared,and the serum Cys-C,urine UTRF,UmAlb single or combined detection of specificity,sensitivity and accuracy was calculated.Results The serum Cys-C,urinary UTRF,UmAlb and 24 h urinary protein levels in observation group B were higher than those in control group,and those in observation group A were higher than those in observation group B,and the differences were significant(P<0.05).The accuracy of the combined detection was higher than that of single detection of serum Cys-C,UTRF,UmAlb or 24 h urine protein.The sensitivity of combined detection was higher than that of UTRF,and the specificity was higher than that of serum Cys-C,and the differences were significant(P<0.05).Conclusions Serum Cys-C combined with UTRF,UmAlb and 2 h urinary protein levels for early DN detection has a high positive detection rate,which can effectively improve the detection accuracy,help to control the progress of the disease and improve the prognosis of patients.