尿蛋白定量检测在糖尿病肾损害诊断中的临床意义

The Clinical Significance of Quantitative Detection of Urinary Protein in the Diagnosis of Diabetic Renal Damage

目的探讨联合检测尿微量白蛋白(urinary microalbumin,mALB)、24h尿蛋白定量(24-hour urinary protein quantification,UCFP)、血糖(glucose,GLU)、总蛋白(total protein,TP)四项生化指标在糖尿病肾损害诊断中的应用价值。方法分别检测健康体检组、尿蛋白阴性糖尿病组和尿蛋白阳性糖尿病组mALB、UCFP、GLU、TP四项生化指标,比较结果间差异无统计学意义。结果尿蛋白阴性糖尿病患者和尿蛋白阳性糖尿病患者标本中TP和GLU检测结果间差异无统计学意义(P>0.05),而mALB、UCFP的检测结果差异有统计学意义(P<0.05)。对于尿蛋白阴性糖尿病患者和正常健康对照组的4项生化指标的比较发现,TP检测结果间差异无统计学意义(P>0.05),而mALB、UCFP、GLU的检测结果差异有统计学意义(P<0.05)。ROC曲线显示尿蛋白阴性糖尿病患者和正常健康对照组之间mALB、UCFP和GLU值曲线下面积分别为0.926、0.904和0.784,有统计学意义(P<0.05)。尿蛋白阴性组和尿蛋白阳性组之间mALB和UCFP值曲线下面积分别为0.875和0.845,有统计学意义(P<0.05)。结论糖尿病患者实时监测mALB、UCFP、GLU水平可以及时发现患者早期肾脏的损害。

Objective To explore the value of combined detection of 24-hour urinary microalbumin,24-hour urinary protein quantification,blood sugar,total protein in the diagnosis of diabetic renal damage.Methods Four biochemical indices,including mALB,UCFP,GLU and TP,were detected in the healthy group,urinary protein negative diabetic group and urinary protein positive diabetic group,respectively.Results There were no significant differences in TP and GLU between the urinary protein negative diabetes group and urinary protein positive diabetes group(P>0.05),while there were significant differences in mALB and UCFP(P<0.05).There was no significant difference in TP between the urinary protein negative diabetes group and normal group(P>0.05),while there were significant differences in mALB,UCFP and GLU(P<0.05).ROC curve showed that the areas under the curves were 0.926,0.904,and 0.784 for mALB,UCFP and GLU between the urinary protein negative diabetes group and normal group,respectively(P<0.05).ROC curve also showed that the areas under the curves were 0.875 and 0.845 for mALB and UCFP between the urinary protein negative diabetes group and urinary protein positive diabetes group,respectively(P<0.05).Conclusion Monitoring levels of mALB,UCFP and GLU in diabetic patients can facilitate the detection of kidney damage in time,which can help clinicians to pay attention to the kidney status of diabetic patients,control blood sugar,adjust renal function and reduce protein loss.