β_2-微球蛋白、胱抑素C及尿微量白蛋白检测在糖尿病肾病诊断中的应用价值分析
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摘要
目的探讨β_2-微球蛋白(β_2-Microglobulin,β_2-MG)、胱抑素C(Cystatin C,CysC)及尿微量白蛋白(Urinary Mmicroalbumin,mAlb)检测在糖尿病肾病诊断中的应用价值。方法选取2017年3月-2018年2月在本院就诊的2型糖尿病患者150例,其中单纯糖尿病患者51例为对照组,早期糖尿病肾病48例为A组,糖尿病肾病51例为B组,均行β_2-MG、CysC及尿mAlb检测,比较3组β_2-MG、CysC及尿mAlb水平及其阳性率,并行相关性分析。结果 B组β_2-MG、CysC及尿mAlb水平明显高于A组和对照组,A组β_2-MG、CysC及尿mAlb水平高于对照组,差异均有统计学意义(P<0.05);联合检测各组患者阳性检出率均明显高于β_2-MG、CysC及尿mAlb指标单独检测,差异有统计学意义(P<0.05);经Pearson分析,β_2-MG、CysC及尿mAlb水平与糖尿病肾病发展呈正相关(P<0.05)。结论β_2-MG、CysC及尿mAlb联合检测可提高糖尿病肾病的阳性检出率,且各项指标的水平与病情发展呈正相关,有助于诊断早期糖尿病肾病。
Objective To investigate the application value of β_2-microglobulin(β_2-MG), Cystatin C(CysC) and urinary microalbumin(mAlb) detection in the diagnosis of diabetic nephropathy(DN). Methods 150 patients with type 2 diabetes mellitus in our hospital from March 2017 to February 2018 were selected, including 51 cases of simple diabetes(control group), 48 cases of early DN(A group) and 51 cases of DN(B group). All the patients underwent β_2-MG, CysC and urinary mAlb detection. The levels and positive rates of β_2-MG, CysC and urinary mAlb were compared among the three groups, and the correlation was analyzed. Results The levels of β_2-MG, CysC and urinary mAlb in B group were higher than those in A group and control group, and the levels of β_2-MG, CysC, urinary mAlb in A group were higher than control group, with the differences statistically significant(P<0.05); The positive detection rate of joint detection was higher than that of single detection of β_2-MG, CysC, urinary mAlb, with the differences statistically significant(P<0.05); According to Pearson analysis, the levels of β_2-MG, CysC, urinary mAlb had positive correlation with the development of DN(P<0.05). Conclusion The joint detection of β_2-MG, CysC and urinary mAlb can increase the positive detection rate of DN. The levels of β_2-MG, CysC, urinary mAlb have positive correlation with the development of DN, which is beneficial to diagnosing early DN.
Objective To investigate the application value of β_2-microglobulin(β_2-MG), Cystatin C(CysC) and urinary microalbumin(mAlb) detection in the diagnosis of diabetic nephropathy(DN). Methods 150 patients with type 2 diabetes mellitus in our hospital from March 2017 to February 2018 were selected, including 51 cases of simple diabetes(control group), 48 cases of early DN(A group) and 51 cases of DN(B group). All the patients underwent β_2-MG, CysC and urinary mAlb detection. The levels and positive rates of β_2-MG, CysC and urinary mAlb were compared among the three groups, and the correlation was analyzed. Results The levels of β_2-MG, CysC and urinary mAlb in B group were higher than those in A group and control group, and the levels of β_2-MG, CysC, urinary mAlb in A group were higher than control group, with the differences statistically significant(P<0.05); The positive detection rate of joint detection was higher than that of single detection of β_2-MG, CysC, urinary mAlb, with the differences statistically significant(P<0.05); According to Pearson analysis, the levels of β_2-MG, CysC, urinary mAlb had positive correlation with the development of DN(P<0.05). Conclusion The joint detection of β_2-MG, CysC and urinary mAlb can increase the positive detection rate of DN. The levels of β_2-MG, CysC, urinary mAlb have positive correlation with the development of DN, which is beneficial to diagnosing early DN.
引文
[1] 朱佳,李志辉.金水宝胶囊联合缬沙坦对2型糖尿病肾病患者炎症因子、血压及肾功能影响的研究[J].现代中西医结合杂志,2017,26(23):2549-2552.
[2] Takazakura A,Sakurai M,Bando Y,et al.Renoprotective effects of atorvastatin compared with pravastatin on progression of early diabetic nephropathy[J].J Diabetes Investig,2015,6(3):346-353.
[3] 刘敏杰,张晓平,谢春福,等.血清Hcy与CysC对早期2型糖尿病肾病的临床诊断价值分析[J].现代生物医学进展,2017,17(7):1360-1363.
[4] Guo KF,Lu JX,Kou JX,et al.Increased urinary Smad3 is significantly correlated with glomerular hyperfiltration and a reduced glomerular filtration rate and is a new urinary biomarker for diabetic nephropathy[J].BMC nephrology,2015,16(1):159.
[5] 刘超,李强,刘彦,等.前列地尔联合强化阿托伐他汀预防糖尿病肾病患者对比剂急性肾损伤的临床研究[J].医学研究杂志,2017,46(8):76-79.
[6] 李仲廷.联合检测β2-微球蛋白和尿微量蛋白对糖尿病肾病早期诊断的临床意义[J].中国实验诊断学,2017,21(8):1372-1374.
[7] Zhuang Z,Bai Q,Liang YX,et al.Increased urinary angiotensinogen precedes the onset of albuminuria in normotensive type 2 diabetic patients[J].Int J Clin Exp Pathol,2015,8(9):11464-11469.
[8] 黄炎,黄伟,章爽,等.血清NGAL、hs-CRP、CysC和U-mALB对糖尿病肾病早期诊断价值的初步探讨[J].实用预防医学,2017,24(10):1168-1171.
[9] 冯雪凤,李爱梅,许守林,等.肾小球滤过率、尿微量白蛋白、血β2-微球蛋白和胱抑素C诊断糖尿病肾病的临床价值[J].中华核医学与分子影像杂志,2017,37(6):331-336.
[10] 贾良勇,李慧,李刘倩,等.早期糖尿病肾病患者联合检测血清CysC与尿mALB/Cr的临床意义[J].中国实验诊断学,2017,21(2):238-240.
[11] Javanmardi M,Azadi NA,Amini S,et al.Diagnostic value of cystatin C for diagnosis of early renal damages in type 2 diabetic mellitus patients:The first experience in Iran[J].J Res Med Sci,2015,20(6):571-576.
[12] 张关亭.CysC、β2微球蛋白、肌酐、尿素氮在2型糖尿病肾病不同阶段的水平变化及诊断价值[J].中华全科医学,2017,15(5):850-852.
[13] Liu FX,Guo J,Zhang Q,et al.The Expression of Tristetraprolin and Its Relationship with Urinary Proteins in Patients with Diabetic Nephropathy[J].PloS one,2015,10(10):e0141471.
[14] 高金芳,张莉,顾红霞,等.血清RBP,Hcy,Cys C及尿m ALB水平在糖尿病肾病早期诊断中的临床应用[J].现代生物医学进展,2017,17(2):317-319.
[15] 热孜万古丽·阿布都拉,宋雪.厄贝沙坦联合阿托伐他汀治疗对早期糖尿病肾病患者血清Cys C、Hcy、TNF-α、ET、TGF-b1水平的影响[J].海南医学院学报,2017,23(20):2776-2778,2782.
[2] Takazakura A,Sakurai M,Bando Y,et al.Renoprotective effects of atorvastatin compared with pravastatin on progression of early diabetic nephropathy[J].J Diabetes Investig,2015,6(3):346-353.
[3] 刘敏杰,张晓平,谢春福,等.血清Hcy与CysC对早期2型糖尿病肾病的临床诊断价值分析[J].现代生物医学进展,2017,17(7):1360-1363.
[4] Guo KF,Lu JX,Kou JX,et al.Increased urinary Smad3 is significantly correlated with glomerular hyperfiltration and a reduced glomerular filtration rate and is a new urinary biomarker for diabetic nephropathy[J].BMC nephrology,2015,16(1):159.
[5] 刘超,李强,刘彦,等.前列地尔联合强化阿托伐他汀预防糖尿病肾病患者对比剂急性肾损伤的临床研究[J].医学研究杂志,2017,46(8):76-79.
[6] 李仲廷.联合检测β2-微球蛋白和尿微量蛋白对糖尿病肾病早期诊断的临床意义[J].中国实验诊断学,2017,21(8):1372-1374.
[7] Zhuang Z,Bai Q,Liang YX,et al.Increased urinary angiotensinogen precedes the onset of albuminuria in normotensive type 2 diabetic patients[J].Int J Clin Exp Pathol,2015,8(9):11464-11469.
[8] 黄炎,黄伟,章爽,等.血清NGAL、hs-CRP、CysC和U-mALB对糖尿病肾病早期诊断价值的初步探讨[J].实用预防医学,2017,24(10):1168-1171.
[9] 冯雪凤,李爱梅,许守林,等.肾小球滤过率、尿微量白蛋白、血β2-微球蛋白和胱抑素C诊断糖尿病肾病的临床价值[J].中华核医学与分子影像杂志,2017,37(6):331-336.
[10] 贾良勇,李慧,李刘倩,等.早期糖尿病肾病患者联合检测血清CysC与尿mALB/Cr的临床意义[J].中国实验诊断学,2017,21(2):238-240.
[11] Javanmardi M,Azadi NA,Amini S,et al.Diagnostic value of cystatin C for diagnosis of early renal damages in type 2 diabetic mellitus patients:The first experience in Iran[J].J Res Med Sci,2015,20(6):571-576.
[12] 张关亭.CysC、β2微球蛋白、肌酐、尿素氮在2型糖尿病肾病不同阶段的水平变化及诊断价值[J].中华全科医学,2017,15(5):850-852.
[13] Liu FX,Guo J,Zhang Q,et al.The Expression of Tristetraprolin and Its Relationship with Urinary Proteins in Patients with Diabetic Nephropathy[J].PloS one,2015,10(10):e0141471.
[14] 高金芳,张莉,顾红霞,等.血清RBP,Hcy,Cys C及尿m ALB水平在糖尿病肾病早期诊断中的临床应用[J].现代生物医学进展,2017,17(2):317-319.
[15] 热孜万古丽·阿布都拉,宋雪.厄贝沙坦联合阿托伐他汀治疗对早期糖尿病肾病患者血清Cys C、Hcy、TNF-α、ET、TGF-b1水平的影响[J].海南医学院学报,2017,23(20):2776-2778,2782.