血清三叶因子3水平联合尿素、肌酐、胱抑素C及肾小球滤过率估算值在糖尿病肾病诊断中的临床价值探讨

Diagnosis value of trefoil factor 3 combined with urea,creatinine,cystatin C and estimated glomerular filtration rate in diabetic nephropathy

目的探讨血清三叶因子3(TFF3)联合尿素(UREA)、肌酐(Cr)、胱抑素C(Cys-C)及肾小球滤过率估算值(e GFR)在糖尿病肾病中的临床价值。方法应用受试者工作特征曲线分析血清TFF3联合UREA、Cr、Cys-C及e GFR在糖尿病肾病中诊断中的作用。血清TFF3采用酶联免疫吸附试验,UREA、Cr、Cys-C及e GFR应用全自动生化仪进行检测。结果受试者工作特征曲线(ROC)分析显示,TFF3、UREA、Cr、Cys-C、e GFR及联合预测值在糖尿病肾病中诊断中的敏感度和特异度分别为83.87%、63.44%、34.41%、40.86%、51.61%、82.80%和95.35%、95.35%、97.67%、90.70%、100.00%、100.00%;联合预测值AUC明显高于单个检测项目(P <0.01);TFF3 AUC明显高于Cys-C、UREA和e GFR(P <0.01)。在早期糖尿病肾病诊断中,TFF3、UREA、e GFR及联合预测值的敏感度和特异度分别为74.14%、58.62%、39.66%、75.86%和95.35%、95.35%、97.67%、100.00%。Logistic回归分析显示,血清TFF3和UREA为糖尿病肾病或早期糖尿病肾病的预测危险因素(P <0.05)。结论血清TFF3水平是诊断糖尿病肾病或早期糖尿病肾病的一个新的潜在有效指标,联合其他肾功能评估指标具有更高的诊断效能,值得在临床推广应用。

Objective To discuss the clinical value of serum trilobular factor 3( TFF3) combined with urea,creatinine( Cr),cystatin C( Cys-C) and estimated glomerular filtration rate( e GFR) in diabetic nephropathy. Methods The diagnostic role of serum TFF3 combined with urea,Cr,Cys-C and e GFR in diabetic nephropathy was evaluated by using receiver operating characteristic( ROC) curve. Serum levels of TFF3 was determined by enzyme-linked immunosorbent assay( ELISA),and urea,Cr,Cys-C and e GFR were detected by automatic biochemical analyzer. Results ROC curve analysis revealed that the sensitivity and specificity of TFF3,urea,Cr,Cys-C,e GFR and the combined predictive values were 83. 87%,63. 44%,34. 41%,40. 86%,51. 61%,82. 80% and 95. 35%,95. 35%,97. 67%,90. 70%,100. 00% and 100. 00% in diabetic nephropathy,respectively. Area under curve( AUC) of the combined predictive value was significantly higher than single indicator( P < 0. 01). AUC of TFF3 was significantly higher than Cys-C,urea and e GFR,with the differences statistically significant( P < 0. 01). The sensitivity and specificity of TFF3,urea,e GFR and the combined predictive value were 74. 14%,58. 62%,39. 66%,75. 86% and 95. 35%,95. 35%,97. 67% and 100. 00% in early diabetic nephropathy,respectively.Logistic regression analysis showed that serum TFF3 and UREA were predictive risk factors for diabetic nephropathy or early diabetic nephropathy( P < 0. 05). Conclusion Serum TFF3 is a new potential biomarker for the diagnosis of diabetic nephropathy or early diabetic nephropathy. Combination with other renal function assessment indicators showed more diagnostic efficacy and worth for clinical application.