血清S1P及CD69联合检测在糖尿病肾病早期诊断中的临床价值

The clinical value of combined detection of serum S1P and CD69 in the early diagnosis of diabetic nephropathy

目的探讨血清鞘氨醇-1-磷酸及早期活化抗原CD69联合检测在糖尿病肾病早期诊断中的临床价值。方法将84例早期糖尿病肾病患者设为糖尿病肾病组,67例糖尿病患者设为糖尿病组,62名健康志愿者设为对照组。检测3组糖化血红蛋白、鞘氨醇-1-磷酸及早期活化抗原CD69水平。根据糖尿病患者糖化血红蛋白水平分为血糖控制良好组和血糖控制不良组,比较鞘氨醇-1-磷酸及早期活化抗原CD69水平。绘制接受者操作特性曲线比较鞘氨醇-1-磷酸及早期活化抗原CD69单独及联合检测在糖尿病肾病早期诊断中的评估效能。结果糖尿病肾病组鞘氨醇-1-磷酸及早期活化抗原CD69水平显著高于糖尿病组及对照组(P<0.01),糖尿病组显著高于对照组(P<0.01)。血糖控制不良组患者糖化血红蛋白、鞘氨醇-1-磷酸及早期活化抗原CD69水平显著高于血糖控制良好组(P<0.01)。鞘氨醇-1-磷酸及早期活化抗原CD69联合检测的接受者操作特性曲线下面积显著大于单独检测(P<0.05)。结论血清鞘氨醇-1-磷酸及早期活化抗原CD69可作为糖尿病肾病早期诊断的敏感指标,联合检测可提高糖尿病肾病早期诊断率。

Objective To investigate the clinical value of combined detection of serum sphingosine-1-phosphate(S1P)and early activation antigen CD69 in the early diagnosis of diabetic nephropathy.Methods Set 84 patients with early diabetic nephropathy(DN)as DN group,67 diabetic patients as diabetes group,and 62 healthy volunteers as control group.The levels of glycosylated hemoglobin,S1P and early activation antigen CD69 of the three groups were tested.Diabetes patients were divided into well-controlled blood sugar group and poorly-controlled blood sugar group according to the level of glycosylated hemoglobin,compare the S1P and early activation antigen CD69 levels.The receiver operating characteristic curve(ROC)was used to compare the evaluation efficiency of S1P and early activation antigen CD69 alone and in combination in the early diagnosis of DN.Results The levels of S1P and early activation antigen CD69 in the DN group were significantly higher than those in the diabetes group and the control group(P<0.01),and the diabetes group was significantly higher than the control group(P<0.01).The levels of glycosylated hemoglobin,S1P and early activation antigen CD69 in the poorly-controlled blood sugar group were significantly higher than those in the well-controlled blood sugar group(P<0.01).The area under the ROC of the combined detection of S1P and the early activation antigen CD69 was significantly larger than that of the single detection(P<0.05).Conclusions S1P and early activation antigen CD69 can be used as sensitive indicators for the early diagnosis of diabetic nephropathy,and the combined detection can improve the early diagnosis rate of diabetic nephropathy.