血清C肽、尿微量白蛋白及糖化血红蛋白联合检测在糖尿病肾病患者中的临床价值分析

Clinical Value Analysis of Combined Serum C-peptide, Urine Microalbumin and Glycated Hemoglobin Test in Patients with Diabetic Nephropathy

目的 探讨血清C肽(C-PR)、尿微量白蛋白(mAlb)、糖化血红蛋白(HbA1c)联合检测在糖尿病肾病(diabetic nephropathy,DN)中的临床价值。方法 回顾性分析2020年1月—2022年4月扬州市宝应县中医医院收治的90例糖尿病患者资料,其中45例未合并DN为对照组,45例合并DN为观察组,对两组患者分别进行C-PR、mAlb、HbA1c单独检测和C-PR、mAlb、HbA1c三者联合检测。对比两组指标水平差异,分析C-PR、mAlb、HbA1c及联合检测在DN诊断中的灵敏度、特异度。结果 观察组C-PR、mAlb、HbA1c指标水平高于对照组,差异有统计学意义(P<0.05)。C-PR在DN诊断中的灵敏度、特异度分别为82.22%、75.56%。mAlb在DN诊断中的灵敏度、特异度分别为88.89%、64.44%。HbA1c在DN诊断中的灵敏度、特异度分别为95.56%、31.11%。C-PR、mAlb、HbA1c联合检测在DN诊断中的灵敏度、特异度分别为97.78%、93.33%。结论 C-PR、mAlb、HbA1c联合检测在DN诊断中具有较高价值,相较上述指标单独检测具有更高的灵敏度或特异度,能提升糖尿病患者合并DN的检出率,使患者及早得到规范化的治疗。

Objective To investigate the clinical value of combined serum C-peptide(C-PR), urinary microprotein(mAlb) and glycated hemoglobin(HbA1c) in diabetic nephropathy(DN).Methods The data of 90 patients with diabetes admitted to Yangzhou Baoying County Hospital of Traditional Chinese Medicine from January 2020 to April 2022were retrospectively analyzed. Among them, 45 patients without DN were in the control group, and 45 patients with DN were in the observation group. C-PR, mAlb, HbA1c independent detection and C-PR, mAlb, HbA1c combined detection were performed in the two groups. The sensitivity and specificity of C-PR, mAlb, HbA1c and combined detection in the diagnosis of DN were analyzed by comparing the difference between the two groups.Results The levels of C-PR,mAlb and HbA1c in observation group were significantly higher than those in control group, and the difference was statistically significant(P<0.05).The sensitivity and specificity of C-PR in the diagnosis of DN were 82.22%and 75.56%, respectively. The sensitivity and specificity of mAlb in the diagnosis of DN were 88.89% and 64.44%, respectively. The sensitivity and specificity of HbA1c in the diagnosis of DN were 95.56% and 31.11%, respectively.The sensitivity and specificity of combined detection of C-PR, mAlb and HbA1c in the diagnosis of DN were 97.78%and 93.33%, respectively.Conclusion The combined detection of C-PR, mAlb and HbA1c has higher value in the diagnosis of DN. Compared with the independent detection of the above indicators, the combined detection of C-PR,mAlb and HbA1c has higher sensitivity or specificity, which can improve the detection rate of diabetes patients with DN and enable patients to receive standardized treatment as soon as possible.