摘要
目的探讨2型糖尿病(T2DM)病患者尿液中的微量白蛋白(MALB)、红细胞(RBC)和血液中的铁蛋白(SF)水平与病情严重程度的关系。方法选取2017年2月至2019年10月在本院接受治疗的174例T2DM患者作为研究对象。根据24 h UAEK将其分为无肾病T2DM组(A组6S例,24 h UAEK<30μg/mg)、微M白蛋白尿组(B组62例,30μg/mg≤24 h UAER≤300μg/mg)、大量白蛋白尿组(C组44例,24 h UAER>300μg/mg)。另选取同期在本院体检的60例健康人群作为对照组:检测并比较各组研究对象清晨尿液的MALB、RBC和血清SF水平,分析各指标水平与病程的关系,应用受试者工作特征(R0C)曲线和曲线下面积(AUC)评价三项指标单独和联合检测在早期UN中的诊断效能结果B组、C组患者尿液中的MALB、RBC计数较对照组和A组升高(P<0.05),C组较B组也明显升高(P<0.05);A、B、C组患者血清SF较对照组均明显升高(P<0.05),B、C组较A组升高(P<0.05),C组较B组也明显升高(P<0.05)。Pearson相关性分析显示,DN患者尿液中MALB、RBC及血液中SF水平均与24 h UAER呈明显正相关(P<0.05)。ROC曲线分析显示,尿液中MALB、RBC和血清SF诊断早期DM的AUC分别为0.762、0.679和0.630,三项指标联合检测的AUC为0.921,相比任一指标单独检测明显提高。结论尿液MALB、RBC计数和血清SF检测对早期DN的诊断和病情严重程度的评价有重要临床价值,三项指标联合检测能明S提高早期UN的珍断效能。
Objective To investigate the relationship between the monitoring level ol mi-croalbumin(MALB),red blood cell(RBC)in the urine and serum ferritin(SF)and the severity of type 2 diabetes mellitus(T2DM)nephropathy(DN).Methods From February 2017 to October 2019,174 T2DM patients were selected as the researc h objects of DM group.According to the 24-hour UAER,they were divided into non nephrotic T2DM group(group A,68 cases,24 h UAER<30μg/mg),microalbuminuria group(group B,62 cases,30μg/mg≤24 h UAER≤300μg/mg),massive white egg white urine group(group C,44 cases,24 h UAER>300μg/mg).Sixty healthy subjects were selected as the healthy control group.The early morning urine MALB,KBC and serum SF levels of each group were detected and compared,and the relationship between them and the severity of the disease was analyzed.The diagnostic efficacy of three indicators in early DN was evaluated by ROC and AUC.Results Compared with the control group and group A,the urinary MALB and RBC of group B and group C was significantly higher,and group C was also significantly higher compared with group B(P<0.05).There was no significant difference between group A and the control group(P>0.05).The SF of group A,B and C was significantly higher than that of the control group,B and C were also significantly higher than that of group A,and C was also significantly higher than that of group B(P<0.05).Pearson correlation analysis showed that there was a significant positive correlation(P<0.05)between urinary MALB,RBC and blood SF levels and 24 h UAER in DN patients.KOC curve analysis showed that AUC of urinary MALB,RBC and serum SK in early diagnosis of DM was 0.762,0.679 and 0.630,respectively,and AUC of combined detection of three indicators was 0.921,which was significantly higher than that of single detection of any indicator.Conclusions U-rine MALB,RBC count and serum SF detection have important clinical value for the diagnosis of early DN and the evaluation of the severity of the disease.The combined detection of the three indicators can significantly improve the diagnostic efficiency of early DN.
作者
吴小冬
尹宝枝
Wu Xiaodong;Yin Baozhi(Department of Nephrology,the First People's Hospital of Anqing City,Anqing 246001,China;Department of Obstetrics and Gynecology,New District,the First Peoples Hospital of Anqing City,Anqing 246001,China)
出处
《国际泌尿系统杂志》
2021年第4期677-681,共5页
International Journal of Urology and Nephrology
