血清胱抑素C、脂蛋白a、尿微量白蛋白联合检测对糖尿病慢性肾病的诊断意义

Diagnostic Significance of Serum Cystatin C,Lipoprotein A and Urinary Microalbumin Combined Detection in Diabetic Chronic Kidney Disease

目的探究血清胱抑素C(cystatin C,CysC)、脂蛋白a(lipoprotein-a,LP-a)、尿微量白蛋白(microalbumin,mAlb)联合检测在糖尿病慢性肾病(diabetic kidney disease,DKD)中的诊断价值。方法选取2019年5月—2021年5月聊城市东昌府人民医院收治的糖尿病患者151例,依据24 h血清尿蛋白排泄率(urinary albumin excretion rates,UAER)分为DKD组(UAER为30~300 mg/24 h)(n=70)及单纯糖尿病组(UAER<30 mg/24 h)(n=81),另选择同期在本院行健康体检的40例体检者作为对照组,比较3组CysC、LP-a、尿mAlb水平;另外,绘制受试者工作曲线(receiver operating characteristic curve,ROC),探究3者单独与联合检测DKD的效能。结果DKD组CysC、LP-a、尿mAlb水平均高于单纯糖尿病组及对照组,差异有统计学意义(P<0.05)。ROC结果显示:CysC、LP-a、尿mAlb3者联合检测的曲线下面积(AUC)明显高于3者单独检测。结论CysC、LP-a、尿mAlb在DKD患者中呈高表达状态,3者联合检测可有效提高疾病的早期检出精准度,可将其作为诊断DKD的重要依据。

Objective To explore the combined diagnostic value of serum cystatin C(CysC),lipoprotein a(LP-a),uri⁃nary microalbumin in patients with diabetic chronic kidney disease(DKD).Methods A total of 151 patients with dia⁃betes treated in Dongchangfu People's Hospital of Liaocheng City from May 2019 to May 2021 were selected.Accord⁃ing to urinary albumin excretion rates(UAER)at 24 h,they were divided into DKD group(UAER 30-300 mg/24 h)(n=70)and simple diabetes group(UAER<30 mg/24 h)(n=81).In addition,40 patients who underwent physical examina⁃tion in our hospital during the same period were selected as the control group,and the levels of CysC,LP-a and uri⁃nary mAlb were compared among the three groups.In addition,receiver operating characteristic curve(ROC)was plot⁃ted to explore the efficiency of DKD detection by the three methods alone and in combination.Results The levels of CysC,LP-a and urinary mAlb in DKD group were higher than those in simple diabetes group and control group,and the difference was statistically significant(P<0.05).The ROC results showed that the area under the curve(AUC)of CysC,LP-a,and urine mAlb 3 detected jointly was significantly higher than that of the three detected separately.Conclusion CysC,LP-a and urinary mAlb are highly expressed in DKD patients,and the combined detection of the three can effectively improve the early detection accuracy of the disease,which can be used as an important basis for the diagnosis of DKD.