尿微量白蛋白、β2-微球蛋白及血清胱抑素C联合检测在糖尿病肾病早期诊断中的应用价值

Application Value of Combined Detection of Urine Microalbumin,β2 Microglobulin and Serum Cystatin C on Early Diagnosis of Diabetic Nephropathy

目的:探讨尿微量白蛋白(mALB)、β2-微球蛋白(β2-MG)及血清胱抑素C(Cys-C)联合检测在糖尿病肾病早期诊断中的应用价值。方法:选取2018年1月-2021年1月鄂州市鄂钢医院收治的80例糖尿病患者作为研究对象,均开展mALB、β2-MG、Cys-C检测,以肾穿刺病理检查结果为“金标准”,观察糖尿病肾病检出情况,比较mALB、β2-MG、Cys-C单独检测与联合检测对糖尿病肾病的诊断效能以及无肾病的糖尿病患者与糖尿病肾病患者mALB、β2-MG、Cys-C水平。结果:80例糖尿病患者经肾穿刺病理检查结果显示,糖尿病肾病56例,检出率为70.00%。mALB、β2-MG、Cys-C联合检测诊断糖尿病肾病的灵敏度、准确性、阳性预测值高于各项单一检测,差异有统计学意义(P<0.05);mALB、β2-MG、Cys-C各项单一检测诊断糖尿病肾病的灵敏度、准确性、阳性预测值比较,差异无统计学意义(P>0.05)。糖尿病肾病患者mALB、β2-MG、Cys-C水平均高于无肾病的糖尿病患者,差异有统计学意义(P<0.001)。结论:mALB、β2-MG、Cys-C联合检测在糖尿病肾病诊断中的应用价值显著,能够提升诊断灵敏度、准确性、阳性预测值,为指导临床诊断、治疗糖尿病肾病提供科学依据。

Objective:To explore the application value of combined detection of urine microalbumin(mALB),β2 microglobulin(β2-MG)and serum cystatin C(Cys-C)on early diagnosis of diabetic nephropathy.Methods:A total of 80 patients with diabetes mellitus treated in Ezhou Egang Hospital from January 2018 to January 2021 were selected as the study subjects.The mALB,β2-MG and Cys-C were tested.The renal puncture pathological examination results were used as gold standard.The detection of diabetic nephropathy was observed,and the diagnostic efficiency of mALB,β2-MG and Cys-C alone and combined detection for diabetic nephropathy and the mALB,β2-MG and Cys-C levels in diabetic patients without nephropathy and diabetic nephropathy patients were compared.Results:The pathological examination results of renal puncture in 80 diabetic patients showed that,there were 56 patients with diabetic nephropathy,and the detection rate was 70.00%.The sensitivity,accuracy,and positive predictive value of combined detection of mALB,β2-MG,and Cys-C in the diagnosis of diabetic nephropathy were higher than those of the individual detection,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the sensitivity,accuracy,and positive predictive value among the individual detection of mALB,β2-MG,and Cys-C in the diagnosis of diabetic nephropathy(P>0.05).The levels of mALB,β2-MG and Cys-C in diabetic nephropathy patients were higher than those in diabetic patients without nephropathy,and and the difference was statistically significant(P<0.001).Conclusion:The combined detection of mALB,β2-MG and Cys-C in the diagnosis of diabetic nephropathy has significant application value,and can improve the diagnostic sensitivity,accuracy and positive predictive value,and provide a scientific basis for guiding the clinical diagnosis and treatment of diabetic nephropathy.