血清胎球蛋白α与β2-微球蛋白联合检测对糖尿病肾病的早期诊断价值

Value of combined detection of serum fetuinαandβ2-microglobulin in early diagnosis of diabetic nephropathy

目的探讨血清胎球蛋白α与β2-微球蛋白(β2-MG)联合检测对糖尿病肾病的早期诊断价值。方法选取2018年8月至2019年8月南阳市第一人民医院收治的93例2型糖尿病患者为研究对象,根据尿微量白蛋白排泄率(UAER)将其分为A组(UAER<20μg/min,29例)、B组(20μg/min≤UAER≤200μg/min,36例)、C组(UAER>200μg/min,28例),再选取同期健康体检者30例为对照组。比较各组间血清胎球蛋白α、β2-MG水平,采用Pearon相关性分析UAER与血清胎球蛋白α、β2-MG水平间的关系,采用受试者工作特征曲线(ROC)分析血清胎球蛋白α、β2-MG水平对早期糖尿病肾病的诊断价值。结果对照组、A组、B组、C组血清β2-MG水平依次呈上升趋势,差异有统计学意义(P<0.05);对照组、A组、B组、C组血清胎球蛋白α水平依次呈下降趋势,差异有统计学意义(P<0.05)。UAER与血清β2-MG水平呈正相关(r=0.434,P<0.05),与血清胎球蛋白α水平呈负相关(r=-0.386,P<0.05)。血清β2-MG诊断早期糖尿病肾病的ROC下面积为0.858,灵敏度为77.40,特异度为93.50;血清胎球蛋白α诊断早期糖尿病肾病的ROC下面积为0.763,灵敏度为51.60%,特异度为86.00%;血清胎球蛋白α联合β2-MG诊断早期糖尿病肾病的ROC下面积为0.967,灵敏度为90.30%,特异度为98.90%。结论血清胎球蛋白α、β2-MG水平与糖尿病肾病患者早期肾损伤有显著相关性,胎球蛋白α联合β2-MG诊断早期糖尿病肾病的价值均高于任何单一指标。

Objective To investigate the value of combined detection of serum fetuinαandβ2-microglobulin(β2-MG)in early diagnosis of diabetic nephropathy.Methods A total of 93 patients with type 2 diabetes mellitus treated in Nanyang First People’s Hospital from August 2018 to August 2019 were selected and divided into three groups according to the urinary albumin excretion rate(UAER),group A(UAER<20μg/min,n=29),group B(20μg/min≤UAER≤200μg/min,n=36)and group C(UAER>200μg/min,n=28).Meanwhile,another 30 healthy persons who had physical exam in the hospital were set as control group.The levels of serum fetuinαandβ2-MG were compared among groups.And the relationships of UAER with levels of serum fetuinαandβ2-MG were analyzed by Pearson correlation analysis.Moreover,the value of serum fetuinαandβ2-MG in the early diagnosis of diabetic nephropathy were analyzed by receiver operating characteristic(ROC)curve.Results The serumβ2-MG level in the group C was the highest,followed by group B,group A and control group sequentially(P<0.05);while the serum fetuinαlevel in the control group was the highest,followed by group A,group B,and group C sequentially(P<0.05).UAER was positively correlated with serumβ2-MG level(r=0.434,P<0.05),and negatively correlated with serum fetuinαlevel(r=-0.386,P<0.05).In the diagnosis of early diabetic nephropathy,the area under the ROC curve,sensitivity and specificity were 0.858,77.40 and 93.50 in serumβ2-MG detection,which were 0.763,51.60 and 86.00 in serum fetuinαdetection,and were 0.967,90.30 and 98.90 in combined detection of serum fetuinαandβ2-MG.Conclusions The serum fetuinαandβ2-MG levels are significantly with early renal damage in patients with diabetic nephropathy.The diagnostic value of serum fetuinαcombined withβ2-MG was superior to two single indicator detections for early diabetic nephropathy.