尿肾功能指标在糖尿病肾病早期肾损伤中的评估价值

Evaluation Value of Urinary and Renal Function Indexes in Early Renal Injury of Diabetic Nephropathy

【目的】探讨尿肾功能指标在糖尿病肾病(DN)早期肾损伤中的评估价值。【方法】选择2017年6月至2018年6月在本院诊治的2型糖尿病(T2DM)患者50例。根据患者尿微量白蛋白(MA)水平分为糖尿病肾脏损伤组(MA >23 mg/L,观察组,n=18)和糖尿病无肾脏损伤组(MA≤23 mg/L,对照组,n=32)。比较两组患者N-乙酰-D-氨基葡萄糖苷酶(NAG)、MA、β2-微球蛋白(β2-MG)、胱抑素-C(Cys-C)、视黄醇结合蛋白(RBP)水平的差异,分析各检测指标确诊DN早期肾损伤的ROC曲线。【结果】两组患者肌酐(Cr)、血尿素氮(BUN)水平比较差异无统计学意义(P>0.05);观察组患者NAG、RBP、β2-MG、Cys-C水平高于对照组,其差异有统计学意义(P<0.05)。NAG、RBP、β2-MG、Cys-C在ROC曲线中的AUC分别为0.894、0.926、0.937、0.984;Cr、BUN的AUC分别为0.513、0.433。【结论】NAG、RBP、β2-MG、Cys-C在DN早期肾损伤患者中表达水平较高,且对DN早期肾损伤诊断具有较高的敏感性,可为疾病早期诊治提供依据。

【Objective】To explore the value of urinary and renal function indicators in early renal injury in diabetic nephropathy (DN).【Methods】Fifty patients with type 2 diabetes mellitus (T2DM) were selected from June 2017 to June 2018. According to the level of urinary microalbumin (MA), patients were divided into diabetic kidney injury group (MA>23 mg/L, observation group,n=18) and diabetic non-kidney injury group (MA<23 mg/L, control group,n=32). The levels of N-acetyl-D-glucosaminidase (NAG), MA, beta-2-microglobulin (beta-2-MG), cystatin-C (Cys-C), retinol binding protein (RBP) were compared between the two groups, and the ROC curves of early DN renal injury were analyzed.【Results】There was no significant difference in the levels of creatinine (Cr) and blood urea nitrogen (BUN) between the two groups (P>0.05);the levels of NAG, RBP, beta 2-MG and Cys-C in the observation group were higher than those in the control group (P<0.05). The AUCs of NAG, RBP, beta 2-MG and Cys-C in ROC curve were 0.894, 0.926, 0.937 and 0.984 respectively, and those of Cr and BUN were 0.513 and 0.433 respectively.【Conclusion】NAG, RBP, beta 2-MG and Cys-C are highly expressed in patients with early DN renal injury, and they are highly sensitive to the diagnosis of early DN renal injury, which can provide a basis for early diagnosis and treatment of diseases.