摘要
目的 探讨尿Ⅳ型胶原（IVC）、尿微量白蛋白与尿肌酐比值（UmAlb/UCr）两种指标用于糖尿病肾病（DN）早期诊断的临床价值.方法 收集糖尿病（DM）无DN期[24 h尿微量白蛋白排泄率（UAE）＜30 mg/24 h]病例52例（A组）,DM合并DN早期（UAE为30～300 mg/24 h）病例35例（B组）,健康对照组50例,比较A、B 2组尿IVC、UmAlb/UCr检测结果及与健康对照组的差异,并利用ROC曲线评价尿IVC、UmAlb/UCr 2种指标在DN早期中的诊断效能,以及对尿IVC、UmAlb/UCr与UAE作相关性分析和显著性检验.检测方法：尿IVC采用化学发光法,尿UmAlb采用免疫比浊法,UCr检测采用酶法,统计工具采用SPSS 13.0统计软件.结果 A组、B组和健康对照组的尿IVC检测结果分别为（2.64±0.91）、（3.91±1.93）、（10.08±6.50）μg/L,UmAlb/UCr检测结果分别为（1.50±0.40）、（2.58±2.10）、（17.95±13.38）mg/mmol,A组与B组的尿IVC、UmAlb/UCr和健康对照组比较差异均有统计学意义（P均＜0.01）;尿IVC、UmAlb/UCr的ROC曲线下面积（AUCBOC）分别为0.724、0.945,2种指标用于DN早期诊断有统计学意义（P均＜0.01）;尿IVC、UmAlb/UCr与UAE的pearson相关系数分别为0.529、0.919（P均＜0.01）,根据相关系数,UmAlb/UCr与UAE的相关性好于尿IVC.结论 尿IVC、UmAlb/UCr用于DN早期诊断均有统计学意义,可作为DN早期的敏感诊断指标,UmAlb/UCr与UAE的相关性好于尿IVC.
Objective To study the clinical significance of urinary type Ⅳ collagen（IVC）and UmAlb/UCr ratio in the diagnosis of early diabetic nephropathy. Methods We collected 52 cases of diabetes（group A）without DN（UAE 〈30 mg/24 h）,35 cases of diabetes（group B）with early DN（UAE as 30-300 mg/24 h）,and 50 cases of healthy controls. The differences of urine IVC,UmAlb/UCr were compared among group A,B and the control group. ROC curve was used for evaluating the use of urine IVC and UmAlb/UCr in the diagnosis of early DN. The correlation of urine IVC and UmAlb/UCr with UAE were investigated,and linear model curve were established. IVC in urine was detected by chemiluminescence,UmAlb was detected by immunoturbidimetric assay,UCr was detected by enzymatic. Statistical analysis were performed with SPSS13.0 statistical software. Results The urine IVC testing of group A,B and the control group were（2. 64 ± 0. 91）,（3.91 ± 1.93）and（10. 08 ± 6. 50）μg/L,respectively. The UmAlb/UCr（mg/mmol）testing of group A,B and the control group were（1.50 ± 0. 40）,（2. 58 ±2. 10）and（17.95 ± 13. 38）mg/mmol,respectively. Urine IVC and UmAlb/UCr were significant difference between group A,B and the control group（Ps 〈 0. 01）;the ROC area under the curve（AUCROC）of urine IVC and UmAlb/UCr were 0. 724,0. 945,the two indicators for early diagnosis of DN were significant（Ps 〈 0. 01）;The pearson correlation coefficients of the urine IVC and UmAlb/UCr were 0. 529,0. 919 ,respectively. They were positive and significant correlation（Ps 〈 0. 01）,On the basis of the correlation coefficient and linear model fitting curve with the UAE,the relationship of UmAlb/UCr with the UAE was better than that of IVC. Conclusions Urine IVC and UmAlb/UCr ratio,which significantly assists diagnosis in diabetic nephropathy ,can be used as a sensitive diagnostic indicator of diabetic nephropathy. Moreover,the relationship of UmAlb/UCr with the UAE is better than that with IVC.
出处
《中国综合临床》
2010年第11期1142-1144,共3页
Clinical Medicine of China
基金
广东省佛山市卫生局科研计划项目（2009410）
