摘要
目的探讨尿微量白蛋白(microalbuminuria,mALB)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)和血清胱抑素C(serum cystatin C,Cys-C)联合检测对诊断糖尿病肾病的价值。方法选取2021年1月—2022年12月南通市海门区人民医院收治的67例糖尿病肾病患者作为糖尿病肾病组,根据患者尿蛋白排泄率,将患者分为早期肾损害组(n=41)、中晚期肾损害组(n=26),另选取58例于本院参加健康体检者作为非糖尿病肾病组,比较不同分组患者mALB、HbA1c和Cys-C检测结果,评估该3项指标联合检测对糖尿病肾病的诊断效能,并采用ROC曲线评估检查方法的诊断效能。结果糖尿病肾病组mALB(47.21±7.68)mg/L、HbA1c(9.43±2.59)%、Cys-C(2.57±0.32)mg/L均高于非糖尿病肾病组,差异有统计学意义(t=30.098、5.759、39.199,P<0.05);中晚期肾损害组mALB(84.52±16.24)mg/L、HbA1c(9.47±1.15)%、Cys-C(3.97±0.36)mg/L均高于早期肾损害组,差异有统计学意义(t=16.036、2.907、26.191,P<0.05);mALB+HbA1c+Cys-C联合检测的AUC为0.960,mALB+HbA1c、Cys-C+HbA1c与三项联合检测的AUC对比,差异有统计学意义(χ^(2)=5.276,P=0.022)。结论糖尿病肾病患者mALB、HbA1c和Cys-C水平明显异常,该3项指标联合检测对糖尿病肾病诊断效能高,且中晚期肾损害患者mALB、HbA1c和Cys-C水平明显更高。
Objective To investigate the value of combined test of urinary microalbuminuria(mALB),glycosylated hemoglobin(HbA1c)and serum cystatin C(Cys-C)in the diagnosis of diabetic nephropathy.Methods A total of 67 patients with diabetic nephropathy admitted to Nantong Haimen District People's Hospital from January 2021 to December 2022 were selected as the diabetic nephropathy group.According to the urinary protein excretion rate,the patients were divided into early renal damage group(n=41)and middle-late renal damage group(n=26).In addition,58 patients who participated in the physical examination in our hospital were selected as the non-diabetic nephropathy group.The results of mALB,HbA1c and Cys-C in different groups were compared to evaluate the diagnostic efficacy of the combined detection of these three indicators for diabetic nephropathy.The ROC curve was used to analyze and evaluate the diagnostic efficacy of the examination method.Results The mALB(47.21±7.68)mg/L,HbA1c(9.43±2.59)%,and Cys-C(2.57±0.32)mg/L in the diabetic nephropathy group were higher than those in the non-diabetic nephropathy group,and the differences were statistically significant(t=30.098,5.759,39.199,P<0.05).The mALB(84.52±16.24)mg/L,HbA1c(9.47±1.15)%,and Cys-C(3.97±0.36)mg/L in the middle-late renal damage group were higher than those in the early renal damage group,and the differences were statistically significant(t=16.036,2.907,26.191,P<0.05).The AUC of mALB+HbA1c+Cys-C combined detection was 0.960,and the AUC of mALB+HbA1c,Cys-C+HbA1c and the three combined tesrs were compared,and the difference was statistically significant(χ^(2)=5.276,P=0.022).Conclusion The levels of mALB,HbA1c and Cys-C were significantly abnormal in patients with diabetic nephropathy,and the combined test was highly effective in the diagnosis of diabetic nephropathy,and the levels of mALB,HbA1c and Cys-C were significantly higher in patients with intermediate and advanced kidney damage.
作者
钱姗姗
仲泳萍
周亮
QIAN Shanshan;ZHONG Yongping;ZHOU Liang(Department of Laboratory,Nantong Haimen District People's Hospital,Haimen,Jiangsu Province,226100 China)
出处
《系统医学》
2023年第15期13-16,37,共5页
Systems Medicine
