视黄醇结合蛋白联合胱抑素C应用于早期糖尿病肾病诊断中的效果分析

Analysis of the effect of retinol-binding protein combined with cystatin C in the diagnosis of early diabetic nephropathy

目的探讨视黄醇结合蛋白(RBP)联合胱抑素C(Cys C)应用于早期糖尿病肾病(DN)诊断中的效果。方法回顾性分析112例2型糖尿病患者的临床资料,其中早期2型糖尿病合并DN患者46例(早期DN组)、单纯2型糖尿病患者66例(单纯糖尿病组);另选取同期行健康体检者60例作为对照组。采用全自动生化分析仪检测并比较三组的尿RBP与血清Cys C水平,对比单纯尿RBP检测、单纯血清Cys C检测、尿RBP与血清Cys C联合检测对早期DN的诊断效果。结果早期DN组尿RBP(94.42±20.52)mg/L、血清Cys C(1.89±0.43)mg/L均高于单纯糖尿病组的(70.60±18.60)、(1.42±0.52)mg/L与对照组的(48.44±14.50)、(0.71±0.30)mg/L,差异均具有统计学意义(t=6.390、5.043,13.513、16.632,P=0.000、0.000,0.000、0.000<0.01)。单纯糖尿病组尿RBP与血清Cys C水平均高于对照组,差异均具有统计学意义(t=7.406、9.265,P=0.000、0.000<0.01)。尿RBP与血清Cys C联合检测早期DN的敏感度、特异度、诊断准确率分别为97.83%(45/46)、96.97%(64/66)、97.32%(109/112),均高于单纯尿RBP检测的76.09%(35/46)、80.30%(53/66)、78.57%(88/112),差异具有统计学意义(χ^2=9.583、9.101、18.572,P=0.002、0.003、0.000<0.01);尿RBP与血清Cys C联合检测早期DN的敏感度、特异度、诊断准确率均高于单纯血清Cys C检测的73.91%(34/46)、78.79%(52/66)、76.79%(86/112),差异具有统计学意义(χ^2=9.855、10.241、20.954,P=0.002、0.001、0.000<0.01)。结论尿RBP与血清Cys C联合应用于早期DN中具有显著的诊断效果,值得临床推广。

Objective To discuss the effect of retinol-binding protein(RBP)combined with cystatin C(Cys C)in the diagnosis of early diabetic nephropathy(DN).Methods The clinical data of 112 patients with type 2 diabetes meliitus were retrospectively analyzed,including 46 patients with early type 2 diabetes mellitus combined with DN(early DN group),66 patients with simple type 2 diabetes mellitus(diabetes mellitus group),and another 60 healthy people who underwent the physical examination in the same period were selected as the control group.Automatic biochemical analyzer was used to detect and compare the urine RBP and serum Cys C levels of the three groups.The diagnostic effect of simple urine RBP test,simple serum Cys C test,urine RBP and serum Cys C combined test for early diagnosis of DN were compared.Results The urine RBP(94.42±20.52)mg/L,serum Cys C(1.89±0.43)mg/L of early DN group were higher than those of diabetes mellitus group(70.60±18.60),(1.42±0.52)mg/L and control group(48.44±14.50),(0.71±0.30)mg/L,and the difference was statistically significant(t=6.390,5.043;13.513,16.632,P=0.000,0.000;0.000,0.000<0.01).The urine RBP and serum Cys C of diabetes mellitus group were higher than those of the control group,and the difference was statistically significant(t=7.406,9.265,P=0.000,0.000<0.01).The sensitivity,specificity and diagnostic accuracy of combined detection of urinary RBP and serum Cys C in early DN were 97.83%(45/46),96.97%(64/66)and 97.32%(109/112),respectively,which were higher than those of single detection of urinary RBP 76.09%(35/46),80.30%(53/66)and 78.57%(88/112),and the difference was statistically significant(χ^2=9.583,9.101,18.572,P=0.002,0.003,0.000<0.01).The sensitivity,specificity and diagnostic accuracy of combined detection of urinary RBP and serum Cys C in early DN were higher than that of single detection of serum Cys C 73.91%(34/46),78.79%(52/66),76.79%(86/112),and the difference was statistically significant(χ^2=9.855,10.241,20.954,P=0.002,0.001,0.000<0.01).Conclusion The combined detection of urinary RBP and serum Cys C in early DN has significant diagnostic effect and is worthy of clinical promotion.