摘要
目的探讨尿液单核细胞趋化因子-1(urinemonocyte chemoattractant protein-1,uMCP-1)、尿液肾损伤分子1 (urinekidney injury molecule-1,uKIM-1)及血清胱抑素C (cystatin C,CysC)水平用于糖尿病相关肾病(diabeticnephropathy,DN)的诊断价值。方法回顾性纳入2013年5月至2016年5月住院的2型糖尿病患者112例,根据白蛋白尿程度分为正常(A1期)组(n=41)、微量白蛋白尿(A2期)组(n=39)、重度白蛋白尿(A3期)组(n=32),同时设置健康对照组(n=31)。收集患者外周血检测CysC水平,收集尿液检测uMCP-1及uKIM-1。ROC曲线分析指标诊断DN的临床价值。结果不同分组uMCP-1/uCr、uKIM-1/uCr及血清CysC水平由高至低依次为:A3期组[(146. 47±51. 60) pg/mg、(424. 03±195. 26) pg/mg及(4. 44±1. 90) mg/ml]、A2期组[(114. 34±38. 76) pg/mg、(255. 58±94. 64) pg/mg及(2. 45±0. 91) mg/ml]、A1期组[(79. 06±28. 02) pg/mg、(187. 32±80. 06) pg/mg及(1. 94±1. 22) mg/ml]及健康对照组[(48. 26±18. 98) pg/mg、(69. 94±39. 46) pg/mg及(0. 43±0. 09) mg/ml]。uMCP-1/uCr单独用于诊断T2DM患者存在肾功能损害的AUC为0. 790,uKIM-1/uCr的AUC为0. 786,CysC的AUC为0. 789。uMCP-1/uCr联合CysC的AUC为0. 802,uKIM-1/uCr联合CysC的AUC为0. 786,uMCP-1/uCr、uKIM-1/uCr及CysC联合的AUC为0. 862。结论 uMCP-1、uKIM-1及CysC均可用于诊断T2DM的DN诊断,且三项指标联合的诊断价值更高。
Objective To investigate the diagnostic value of urine monocyte chemoattractant protein 1(uMCP 1), urine kidney injury molecule 1(uKIM-1) and serum cystatin C(CysC) in patients with type 2 diabetes mellitus (T2DM) complicated by diabetic nephropathy (DN). MethodsA total of 112 patients with T2DM who were admitted and treated in our hospital from May 2013 to May 2016 were enrolled in the study. According to the degrees of albuminuria,these patients were divided into stage A1 group ( n =41), microalbuminuria group (stage A2 group, n =39), and severe albuminuria group (stage A3 group, n =32),at the same time, the other 31 healthy subjects were enrolled as control group. The peripheral blood were collected, and the serum CysC levels were detected, moreover the urine specimens were collected,and the levels of uMCP-1, uKIM-1 were detected. The clinical value of these indexes in diagnosis of DN was analyzed by means of ROC curve. ResultsThe levels of uMCP-1/uCr, uKIM-1/uCr and serum CysC levels in different groups from high to low were (146.47± 51.60)pg/mg,(424.03±195.26)pg/mg,(4.44±1.90)mg/ml in stage A3 group,and (114.34±38.76)pg/mg,(255.58± 94.64)pg/mg,(2.45±0.91)mg/ml in stage A2 group,and (79.06±28.02)pg/mg,(187.32±80.06)pg/mg,(1.94± 1.22 )mg/ml in stage A1 group,and (48.26±18.98)pg/mg,(69.94±39.46)pg/mg,(0.43±0.09)mg/ml in control group. The AUC of uMCP-1/uCr in diagnosis of renal function damage was 0.790, the AUC of uKIM-1/uCr was 0.786,and the AUC of CysC was 0.789. The AUC of uMCP-1/uCr combined with CysC was 0.802, the AUC of uKIM-1/uCr combined with CysC was 0.786, the AUC of uMCP-1/uCr and uKIM-1/uCr combined with CysC was 0.862. ConclusionThe uMCP-1, uKIM-1 and CysC can be used for diagnosis of DN in patients with T2DM, and the combination detection of three indexes has higher diagnositic value.
作者
董丽娟
牛奔
马丽
姜晓岚
DONG Lijuan;NIU Ben;MA Li(Department of Internal Medicine,Geriatrics Hospital of Kunming City,Yunnan, Kunming 650011,China)
出处
《河北医药》
CAS
2019年第1期37-41,共5页
Hebei Medical Journal
基金
云南省医学后备人才培养项目(编号:H-201614)
关键词
2型糖尿病
糖尿病相关肾病
单核细胞趋化因子-1
肾损伤分子-1
胱抑素C
肾小球滤过率
type 2 diabetes mellitus
diabetic nephropathy
monocyte chemoattractant protein-1
kidney injury molecule-1
cystatin C
glomerular filtration rate
diagnosis
