尿微量白蛋白、尿α_(1)微球蛋白、尿β_(2)微球蛋白在早期糖尿病肾病中的临床应用价值

The Clinical Application Value of Urine Microalbumin,Urine α_(1) Microglobulin and Urine β_(2) Microglobulin in Early Diabetic Nephropathy

目的分析早期糖尿病肾病(DN)诊断中尿微量白蛋白(mAlb)、尿α_(1)微球蛋白(α_(1)MG)、尿β_(2)微球蛋白(β_(2)MG)的应用效果。方法选取2020年1月—2021年1月滨州医学院附属医院收治的90例2型糖尿病患者,根据UAER水平分为单纯糖尿病组50例和DN组40例,另选取40名同期健康体检者为对照组,比较3组各指标检测结果及异常检出率,并分析各指标单独与联合应用对早期DN的诊断效能。结果DN组的α_(1)MG、mAlb及β_(2)MG水平最高,其次为糖尿病组,与对照组各指标比较均显著较高,差异有统计学意义(P<0.05)。糖尿病组α_(1)MG异常检出率24.00%,mAlb异常检出率14.00%,β_(2)MG异常检出率16.00%,均显著低于DN组的77.50%、72.50%及57.50%,差异有统计学差异(χ^(2)=25.493、31.688、16.949,P<0.05)。尿α_(1)MG、β_(2)MG和mAlb诊断早期DN的灵敏度为72.50%、52.50%和75.00%,与三者联合诊断的90.00%比较均显著较低,差异有统计学意义(P<0.05)。三者诊断早期DN的ROC曲线下面积分别为0.895、0.833和0.889。结论α_(1)MG、mAlb和β_(2)MG对早期DN均具有较高敏感性,将其联合应用能够显著提升临床诊断灵敏度,为临床疾病诊治提供重要依据。

Objective To analyze the application effects of urinary microalbumin(mAlb),urinaryα_(1) microglobulin(α_(1)MG)and urinaryβ_(2) microglobulin(β_(2)MG)in the diagnosis of early diabetic nephropathy(DN).Methods A total of 90 patients with type 2 diabetes who were admitted to the Affiliated Hospital of Binzhou Medical College from January 2020 to January 2021 were selected.According to the UAER level,they were divided into 50 cases in the simple diabetes group and 40 cases in the DN group,another 40 healthy subjects were selected as the control group.Compared the detection results and abnormal detection rate of each index in the three groups,and analyzed the diagnostic efficacy of each index alone and in combination for early DN.Results The levels ofα_(1)MG,mAlb andβ_(2)MG in the DN group were the highest,followed by the diabetes group,which were significantly higher than those in the control group,the difference was statistically significant(P<0.05).The abnormal detection rate ofα_(1)MG in the diabetes group was 24.00%,the abnormal detection rate of mAlb was 14.00%,and the abnormal detection rate ofβ_(2)MG was 16.00%,which were significantly lower than the 77.50%,72.50%and 57.50%of the DN group,the difference was statistically significant(χ^(2)=25.493,31.688,16.949,P<0.05).The sensitivity of urinaryα_(1)MG,β_(2)MG and mAlb to diagnose early DN was 72.50%,52.50%and 75.00%,which were significantly lower than the combined diagnosis of 90.00%,the difference was statistically significant(P<0.05).The area under the ROC curve of the three diagnosed early DN was 0.895,0.833 and 0.889,respectively.Conclusionα_(1)MG,mAlb andβ_(2)MG all have high sensitivity to early DN,and their combined application can significantly improve the sensitivity of clinical diagnosis and provide an important basis for the diagnosis and treatment of clinical diseases.