尿液足细胞标志蛋白水平联合血清炎症因子对糖尿病肾病合并高尿酸血症的诊断价值

Diagnostic value of urine podocalyxin level combined with serum inflammatory factors in diabetic nephropathy complicated with hyperuricemia

目的:探讨尿液足细胞标志蛋白(podocalyxin,PCX)联合血清炎症因子在糖尿病肾病合并高尿酸血症诊断中的应用价值。方法:选取106例糖尿病肾病病人,根据是否合并高尿酸血症,分为糖尿病肾病组(52例)和糖尿病肾病合并高尿酸血症组(54例),在相同的条件下检测并分析比较2组病人尿液PCX水平以及血清中C反应蛋白(CRP)水平、肿瘤坏死因子-α(TNF-α)水平、白细胞介素-6(IL-6)水平、单核细胞趋化蛋白-1(MCP-1)水平及髓过氧化物酶(MPO)水平。结果:糖尿病肾病合并高尿酸血症组病人的PCX、CRP、TNF-α、IL-6及MCP-1等水平皆高于糖尿病肾病组(P<0.01),2组的MPO水平差异无统计学意义(P>0.05)。二元logistic回归分析可知,尿液PCX、血清CRP、TNF-α、IL-6及MCP-1等指标皆为糖尿病肾病合并高尿酸血症的独立危险因素,皆与糖尿病肾病合并高尿酸血症关系密切。PCX、CRP、TNF-α、IL-6及MCP-1联合检测的ROC曲线下面积优于各指标单独诊断的ROC曲线下面积(P<0.05~P<0.01),PCX、CRP、TNF-α、IL-6及MCP-1联合检测的灵敏度及特异性优于各指标单独诊断(P<0.05)。结论:尿液PCX水平联合检测血清炎症因子(CRP、TNF-α、IL-6及MCP-1)对糖尿病肾病合并高尿酸血症具有较高的诊断价值临床应用前景比较广阔。

Objective:To investigate the application value of urinary podocalyxin(PCX)combined with serum inflammatory factors in the diagnosis of diabetic nephropathy complicated with hyperuricemia.Methods:One hundred and six patients with diabetic nephropathy were divided into the diabetic nephropathy group(52 cases)and diabetic nephropathy complicated with hyperuricemia group(54 cases).Under the same conditions,the urine and blood tests were implemented in two groups.The urine PCX levels,and serum levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),monocyte chemotactic protein-1(MCP-1)and myeloperoxidase(MPO)were compared between two groups.Results:The levels of PCX,CRP,TNF-α,IL-6 and MCP-1 in diabetic nephropathy complicated with hyperuricemia group were higher tahn those in diabetic nephropathy group(P<0.01),and the difference of MPO level between two groups was not statistically significnat(P>0.05).The results of binary logistic regression analysis showed that the urine PCX,serum CRP,TNF-α,IL-6 and MCP-1 were the independent risk factors of diabetic nephropathy complicated with hyperuricemia,and closely related to diabetic nephropathy complicated with hyperuricemia.The area under the ROC curve of combined detection of PCX,CRP,TNF-α,IL-6 and MCP-1 was better than that of each index alone(P<0.05 to P<0.01),and the sensitivity and specificity of combined detection of PCX,CRP,TNF-α,IL-6 and MCP-1 and MCP-1 were better than those of individual diagnosis(P<0.05).Conclusions:The urine PCX level combined with serum inflammatory factors(CRP,TNF-α,IL-6 and MCP-1)have high diagnostic value for diabetic nephropathy complicated with hyperuricemia,and broad prospect of clinical application.