Objective:To explore the effect of inflammatory injury and oxidative stress injury on urine microalbumin/creatinine (UACR) and 24 h urine microalbumin (24 h UMA) in patients with diabetic nephropathy.Methods: 54 patie...Objective:To explore the effect of inflammatory injury and oxidative stress injury on urine microalbumin/creatinine (UACR) and 24 h urine microalbumin (24 h UMA) in patients with diabetic nephropathy.Methods: 54 patients with early diabetic nephropathy treated in our hospital between June 2012 and December 2015 were included in early diabetic nephropathy (DN) group and 60 patients with clinical diabetic nephropathy were included in clinical DN group. 50 healthy subjects who received physical examination in our hospital during the same period were included in healthy control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum inflammatory injury index levels;automatic biochemical analyzer was used to determine serum oxidative stress injury index levels;immunoturbidimetry was used to detect 24 h UMA, and UACR level was calculated.Results: Serum interleukin-6 (IL-6), interleukin-18 (IL-18), interleukin-27 (IL-27) and tumor necrosis factor-α (TNF-α) levels of clinical DN group were higher than those of early DN group and healthy control group while IL-10 level was lower than that of early DN group and healthy control group (P<0.05);serum total antioxidant capacity (T-AOC), vitamin C (VitC) and glutathione peroxidase (GSH-Px) levels were lower than those of early DN group and healthy control group while lipid hydrogen peroxide (LHP) and malondialdehyde (MDA) levels were higher than those of early DN group and healthy control group (P<0.05);UACR and 24 h UMA levels were higher than those of early DN group and healthy control group (P<0.05). Spearman correlation analysis showed that UACR and 24 h UMA levels in patients with diabetic nephropathy are directly related to the degree of inflammatory injury and oxidative stress injury.Conclusions: The inflammatory injury and oxidative stress injury directly affect the UACR and 24 h UMA levels in patients with diabetic nephropathy, and are the important determinants for the occurrence and development of disease.展开更多
文摘Objective:To explore the effect of inflammatory injury and oxidative stress injury on urine microalbumin/creatinine (UACR) and 24 h urine microalbumin (24 h UMA) in patients with diabetic nephropathy.Methods: 54 patients with early diabetic nephropathy treated in our hospital between June 2012 and December 2015 were included in early diabetic nephropathy (DN) group and 60 patients with clinical diabetic nephropathy were included in clinical DN group. 50 healthy subjects who received physical examination in our hospital during the same period were included in healthy control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum inflammatory injury index levels;automatic biochemical analyzer was used to determine serum oxidative stress injury index levels;immunoturbidimetry was used to detect 24 h UMA, and UACR level was calculated.Results: Serum interleukin-6 (IL-6), interleukin-18 (IL-18), interleukin-27 (IL-27) and tumor necrosis factor-α (TNF-α) levels of clinical DN group were higher than those of early DN group and healthy control group while IL-10 level was lower than that of early DN group and healthy control group (P<0.05);serum total antioxidant capacity (T-AOC), vitamin C (VitC) and glutathione peroxidase (GSH-Px) levels were lower than those of early DN group and healthy control group while lipid hydrogen peroxide (LHP) and malondialdehyde (MDA) levels were higher than those of early DN group and healthy control group (P<0.05);UACR and 24 h UMA levels were higher than those of early DN group and healthy control group (P<0.05). Spearman correlation analysis showed that UACR and 24 h UMA levels in patients with diabetic nephropathy are directly related to the degree of inflammatory injury and oxidative stress injury.Conclusions: The inflammatory injury and oxidative stress injury directly affect the UACR and 24 h UMA levels in patients with diabetic nephropathy, and are the important determinants for the occurrence and development of disease.
文摘目的分析实验室肾功能检查项目在慢性肾病中的诊断特性。方法将73例慢性肾病患者以肾小球滤过率估算值(eGFR)分成3组[慢性肾病A组:33例,eGFR>60 mL/(min·1.73 m2);慢性肾病B组:32例,eGFR为30～60 mL/(min·1.73 m2);慢性肾病C组:8例,eGFR<30 mL/(min·1.73 m2)]。分别测定慢性肾病组、慢性肾病高危组(糖尿病或高血压40例)和正常对照组(32名)随机尿微量白蛋白(U-mALb)/肌酐(Cr)比值、随机尿蛋白(UP)/Cr比值、24 h尿微量白蛋白(24 h U-mALb)、24 h尿蛋白(24 h UP)以及血清尿素(Urea)、Cr、尿酸(UA)、半胱氨酸蛋白酶抑制剂C(Cys C)水平。比较各组检测结果,并以慢性肾病的检验项目为判断金标准[24 h UP的临界值>150 mg或eGFR<60 mL/(min·1.73 m2)],分别计算其他检验项目的诊断性能(诊断灵敏度、特异性、阴性预期值、阳性预期值、阴性似然比、阳性似然比和准确性)。结果慢性肾病A、B、C 3组之间U-mALb/Cr比值、UP/Cr比值、24 h U-mALb及血清Urea、UA、Cys C检测结果差异均有统计学意义(P<0.05)。慢性肾病A组与慢性肾病高危组比较,除了UA无明显差异外,其余项目检测结果差异均有统计学意义(P<0.05)。慢性肾病高危组和正常对照组之间仅UA、Cys C水平的差异有统计学意义(P<0.05)。U-mAlb/Cr比值、UP/Cr比值、24 h U-mAlb及血清Urea、UA、Cys C对慢性肾病的诊断性能中阴性似然比分别为0.17、0.22、0.14、0.67、0.66、0.51;阳性似然比分别为7.73、78、28.7、34、3.73、5.00;准确性分别为0.87、0.88、0.92、0.66、0.65、0.74。结论 24 h U-mALb在慢性肾病诊断中准确性最高,UP/Cr比值和U-mALb/Cr比值对慢性肾病诊断的准确性最接近24 h U-mALb,故适用于临床筛检慢性肾病。而eGFR主要应用于慢性肾病的分型。
