白细胞介素-17A、白细胞介素-18、趋化因子9、肿瘤坏死因子α联合检测在早期糖尿病肾病诊断的临床研究

Clinical study of combined detection of IL-17A,IL-18,CXCL9,TNF-α in the diagnosis of early diabetic nephropathy

目的探讨白细胞介素-17A(IL-17A)、IL-18趋化因子9(CXCL9)、肿瘤坏死因子a(TNF-x)联合检测在早期糖尿病肾病诊断中的临床价值。方法选取2017年1月至2019年12月在本院就诊的糖尿病肾病患者120例,依据尿白蛋白排泄率(UAER)分成UAER正常组56例及UAER增高组共64例;另选取60例健康人群作为对照组。采用ELISA方法检测血清中IL-17A、L-18、CXCL9、TNF-α的表达水平。结果UAER正常组与UAER增高组患者血清中IL~17A IL-18、CXCL9、TNF-α的表达水平及阳性率均较对照组显著升高(P<0.05)。与UAER正常组相比,UAER增高组患者血清中IL-17A、IL-18、CXCL9、TNF-α表达水平显著升高(P<0.05)。UAER增高组患者血清中IL-17A.JL-18、CXCL9、TNF-α的阳性率较UAER正常组显著升高(P<0.05)。四项指标联合检测对糖尿病肾病诊断的特异度和灵敏度均高于单一检测(P<0.05)。结论IL17A、L-18、CXCL9、TNF-x的检验对早期糖尿病肾病的诊断具有一定参考价值,四项指标联合检验的诊断效能高于单一检测。

Objective To explore the clinical value of the serum level of interleukin-17A(IL-17A),IL-18,Cys-X-Cys ligand-9(CXCL9)and tumor necrosis factorax(TNF-α)in the diagnosis of diabetic nephropathy in patients.Methods From January 2017 to December 2019,120 patients with type 2 diabetes were selected.According to the urinary albumin excretion rate(UAER),56 cases were divided into normal UAER group,64 cases in UAER increased group.Another 60 healthy people were selected as the control group.The serum IL-17A,IL-18,CXCL9 and TNF-αwere detected by ELISA method.Results Compared with the control group,the serum level of IL-17A,IL-18,CXCL9 and TNF-αwere all significantly increased in normal UAER and high UAER patients(P<0.05).The ser~um level of IL17A,IL-18,CXCL9 and TNF-αx were all significantly increased in high UAER patients than normal UAER patients(P<0.05).The positive predictive value of IL-17A,IL-18,CXCL9 and TNF-αwere increased in high UAER patients than normal UAER patients(P<0.05).Four indicators combined detection of diabetic nephropathy in the diagnosis of sensitivity and specific degrees were higher than that of a single test(P<0.05).Conclusions The detection of IL-17A,IL-18,CXCL9 and TNF-c has certain value in the diagnosis of early diabetie nephropathy,and the diagnostic value of combined detection of four indexes is higher than that of one single detection.