联合检测尿特种蛋白对2型糖尿病肾病的早期诊断价值

The Value of Combined Detection of Urine Specific Protein in Early Diagnosis of Type 2 Diabetic Nephropathy

目的探讨联合检测尿转铁蛋白(uTRF)、尿免疫球蛋白(uIgG)与α1-微球蛋白(α1-MG)对2型糖尿病肾病的早期诊断有无意义。方法以尿微量白蛋白(MA)为标准对161例2型糖尿病患者及同期50名健康人进行分组,用美国贝克曼库尔特公司生产的IMMAGE 800特定蛋白分析仪及配套试剂,利用散射免疫比浊法测定尿微量白蛋白、转铁蛋白、尿免疫球蛋白和α1-微球蛋白,找出uTRF、uIgG和α1-MG与24 h尿微量白蛋白(MA)的在诊断2型糖尿病早期肾损伤的关系,并应用ROC曲线确定单一和联合检测对诊断早期DN的价值。结果与NA组、MA组、LA组uTRF、uIgG和α1-MG均高于对照组,并随着DN进展而升高(P均<0.05)。相关分析结果表明,uTRF、uIgG和α1-MG与MA呈正相关(r=0.811、0.863、0.685,P均<0.05)。在NA组中,uTRF、uIgG和α1-MG诊断早期DN的敏感性分别为63.3%、81.7%和51.7%,特异性分别为98.3%、79.3%和81.0%,三者联合检测的敏感性为80.0%,特异性为91.4%。结论 2型糖尿病患者肾损伤时uTRF、uIgG和α1-MG数量显著升高,三者与MA检测对于DN的早期诊断具有重要价值。

Objective To explore the significance of combined detection of urinary transferrin(uTRF), urinary immunoglobulin(uIgG), and α1-microglobulin(α1-MG) in the early diagnosis of type 2 diabetic nephropathy. Methods According to the value of urinary microalbumin(MA), 161 patients with type 2 diabetes mellitus and 50 healthy control in the same period were divided into two groups. IMMAGE800 specific protein analyzer made by Beckman Coulter Company and its supporting reagents were used to determine urinary Microalbumin, transferrin, urinary immunoglobulin, and α1-microglobulin by scatter immune turbidimetry. To find out the relationship between uTRF, uIgG, α1-MG and 24-hour urinary Microalbumin(MA) in the diagnosis of early renal injury in type 2 diabetes mellitus, and to determine the value of single and combined detection in the diagnosis of early DN by ROC curve. Results The levels of uTRF, uIgG and α1-MG in NA group, MA group and LA group were higher than those in the control group, and increased with the progress of DN. The results of correlation analysis showed that uTRF, uIgG and α1-MG were positively correlated with MA(r=0.811, 0.863, 0.685, P<0.05). In the NA group, the sensitivity of uTRF, uIgG and α1-MG in the diagnosis of early DN was 63.3%, 81.7% and 51.7%, and the specificity was 98.3%, 79.3% and 81.0%, respectively. The sensitivity and specificity of combined detection of the three were 80.0% and 91.4%, respectively.Conclusions The values of uTRF, uIgG and α1-MG are significantly increased in patients with type 2 diabetes mellitus with renal injury, the combined detection of the three and MA is of great value for the early diagnosis of DN.