尿转铁蛋白、尿β2-微球蛋白联合尿微量白蛋白诊断早期糖尿病肾病的价值分析

Analysis of the value of urinary transferrin and urinaryβ2-microglobulin combined with urinary microalbumin in the diagnosis of early diabetic nephropathy

目的分析早期糖尿病肾病(DN)采用尿转铁蛋白(TRF)、尿β2-微球蛋白(β2-MG)联合尿微量白蛋白(UAlb)诊断的价值。方法回顾性分析102例2型糖尿病患者资料,根据诊断结果将其分为两组,其中35例早期DN患者为研究组,另67例单纯2型糖尿病患者为对照组。两组患者均接受尿TRF、尿β2-MG、UAlb检验。对比两组尿TRF、尿β2-MG、UAlb水平,对比尿TRF、尿β2-MG、UAlb单独检验与联合检验早期DN的诊断效能(敏感度、特异度、阴性预测值、阳性预测值、准确率)。结果与对照组[(1.20±0.75)、(0.12±0.08)、(15.02±3.00)mg/L]相比,研究组尿TRF、尿β2-MG、UAlb水平[(3.56±0.60)、(0.75±0.18)、(56.52±4.62)mg/L]更高(P<0.05)。尿TRF、尿β2-MG、UAlb联合检验早期DN阳性36例,尿TRF单独检验阳性39例,尿β2-MG单独检验阳性38例,UAlb单独检验阳性37例。尿TRF、尿β2-MG、UAlb联合检验对于早期DN的诊断敏感度97.14%、特异度97.01%、阴性预测值98.48%、阳性预测值94.44%与准确率97.06%均高于单独尿TRF检验的71.43%、79.10%、84.13%、64.10%、76.47%,单独尿β2-MG检验的77.14%、83.58%、87.50%、71.05%、81.37%,单独UAlb检验的77.14%、85.07%、87.69%、72.97%、82.35%(P<0.05)。结论早期DN患者尿TRF、尿β2-MG、UAlb水平可见明显上升,联合检验的诊断价值更高。

Objective To analyze the value of urinary transferrin(TRF)and urinaryβ2-microglobulin(β2-MG)combined with urinary microalbumin(UAlb)in the diagnosis of early diabetic nephropathy(DN).Methods The data of 102 patients with type 2 diabetes were retrospectively analyzed,and they were divided into two groups according to the diagnosis results,including 35 patients with early DN as the study group and 67 patients with simple type 2 diabetes as the control group.Both groups were subjected to urinary TRF,urinaryβ2-MG,and UAlb tests.The levels of urinary TRF,urinaryβ2-MG,and UAlb were compared between the two groups,and the diagnostic efficacy(sensitivity,specificity,negative predictive value,positive predictive value,and accuracy)of the urinary TRF,urinaryβ2-MG,and UAlb tests alone and in combination for early DN.Results Compared with the control group[(1.20±0.75),(0.12±0.08)and(15.02±3.00)mg/L],the study group had higher levels of urinary TRF,urinaryβ2-MG and UAlb[(3.56±0.60),(0.75±0.18)and(56.52±4.62)mg/L](P<0.05).Urinary TRF,urinaryβ2-MG,and UAlb combined test showed 36 positive cases,urinary TRF test showed 39 positive cases,urinaryβ2-MG test showed 38 positive 38 cases,and UAlb test showed 37 positive cases.The diagnostic sensitivity of urinary TRF,urinaryβ2-MG and UAlb combined test for early DN was 97.14%,the specificity was 97.01%,the negative predictive value was 98.48%,the positive predictive value was 94.44%,and the accuracy was 97.06%,all of which were higher than 71.43%,79.10%,84.13%,64.10%and 76.47%of urinary TRF test,77.14%,83.58%,87.50%,71.05%,81.37%of urinaryβ2-MG test,and 77.14%,85.07%,87.69%,72.97%,82.35%of UAlb test(P<0.05).Conclusion The levels of urinary TRF,urinaryβ2-MG,and UAlb in patients with early DN can be seen to rise significantly,and the diagnostic value of the combined test is higher.