血浆NGAL和CysC在糖尿病肾病早期诊断中的应用价值

Application value of plasma NGAL and CysC in the early diagnosis of diabetic nephropathy

目的探究血浆中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和血清胱抑素C(CysC)在糖尿病肾病(DN)早期诊断中的应用价值。方法选取我院2018年1月至2018年12月收治的150例DN患者,设为研究组,依照尿微量白蛋白排泄率(UAER)将其分为甲组(UAER为10~29 mg/24 h,50例)、乙组(UAER为30~300 mg/24 h,50例)、丙组(UAER>300mg/24 h,50例);另选取同时间段于我院进行健康体检的50例自愿者设为对照组。比较四组研究对象的NGAL、CysC、UMA、BUN及CREA水平,分析NGAL、CysC与UMA的相关性。结果四组研究对象的NGAL、CysC、UMA、BUN及CREA水平比较,差异具有统计学意义(P <0. 05)。甲组的NGAL、CysC及UMA水平均高于对照组,差异具有统计学意义(P<0.05);甲组的BUN、CREA水平与对照组比较,差异无统计学意义(P>0.05);乙组的NGAL、CysC及UMA水平均高于对照组和甲组,差异具有统计学意义(P<0.05);乙组的BUN、CREA水平与甲组、对照组比较,差异无统计学意义(P>0.05);丙组的NGAL、CysC、UMA、BUN及CREA水平均高于甲组、乙组及对照组,差异具有统计学意义(P<0.05)。NGAL、CysC与UMA水平呈正相关,差异具有统计学意义(P<0.05)。结论 DN患者的血浆NGAL和CysC均明显升高,而且均与UMA水平呈正相关关系,血浆NGAL和CysC可作为临床DN诊断以及肾脏损害程度评价的敏感生物学标志物,值得临床推广应用。

Objective To explore the application value of plasma neutropil gelatinase-associated lipocalin(NGAL) and serum cystatin C(CysC) in the early diagnosis of diabetic nephropathy(DN). Methods A total of 150 patients with DN admitted in our hospital from January 2018 to December 2018 were selected as the study group. According to the urinary aibumin excretion rate(UAER), the patients were divided into group A(UAER 10-29 mg/24 h, 50 cases), group B(UAER30-300 mg/24 h, 50 cases) and group C(UAER > 300 mg/24 h, 50 cases). Another 50 volunteers who had physical examination in our hospital in the same period were selected as the control group. The levels of NGAL, CysC, UMA, BUN and CREA were compared among the four groups, and the correlation between NGAL, CysC and UMA were analyzed.Results There were significant differences in the levels of NGAL, CysC, UMA, BUN and CREA among the four groups(P <0.05). The levels of NGAL, CysC and UMA in the group A were higher than those in the control group, and the differences were statistically significant(P <0.05);there were no significant differences in the levels of BUN and CREA between the group A and the control group(P>0.05);and the levels of NGAL, CysC and UMA in the group B were higher than those in the control group and group A, and the differences were statistically significant(P <0.05);there were no significant differences in the levels of BUN and CREA between the group B and the group A, control group(P>0.05). The levels of NGAL, CysC, UMA, BUN and CREA in the group C were higher than those in the group A, the group B and control group, and the differences were statistically significant(P<0.05). NGAL and CysC were positively correlated with UMA, and the differences were statistically significant(P<0.05). Conclusion Plasma NGAL and CysC were significantly increased in patients with DN, and positively correlated with UMA level. Plasma NGAL and CysC can be used as sensitive biomarkers for the diagnosis of early DN and the evaluation of renal damage, it is worthy of clinical promotion and application.