摘要
目的明确尿液视黄醇结合蛋白(RBP)、微量白蛋白(MA)、肌酐(Cr)及微量白蛋白与肌酐比值(MA/Cr)在早期糖尿病肾病中的诊断效能。方法将肇庆市第一人民医院2022年2月—2024年2月收治的50例早期糖尿病肾病患者纳入观察组;另外选择同期50例单纯糖尿病患者纳入对照组。所有患者入院后使用全自动特定蛋白仪检测尿液RBP、MA、Cr,计算MA/Cr,比较两组上述指标水平差异;为评估RBP、MA、Cr、MA/Cr单独与联合检测对早期糖尿病肾病的诊断价值,绘制受试者工作特征曲线(ROC曲线)。结果观察组MA、MA/Cr水平均显著高于对照组〔MA(mg/L):376.42±79.39比10.95±2.20;MA/Cr(g/mol):79.55±19.38比1.58±0.30;均P<0.05〕,两组RBP和Cr水平差异均无统计学意义〔RBP(mg/L):3.97±0.96比2.51±0.96;Cr(mmol/L):8.41±0.94比7.88±0.78;均P>0.05〕。尿液RBP、MA、Cr、MA/Cr联合应用诊断早期糖尿病肾病的ROC曲线下面积(AUC)为0.960,敏感度与特异度分别为90.00%、98.00%;联合检测对早期糖尿病肾病的诊断价值优于RBP和Cr单独预测。结论早期糖尿病肾病患者尿液MA、MA/Cr水平均显著高于单纯糖尿病患者,但RBP、Cr变化不明显;尿液RBP、MA、Cr、MA/Cr联合检测诊断早期糖尿病肾病具有较高的特异度,但相较于MA、MA/Cr单独检测总体优势不大。
Objective To investigate the diagnostic value of urinary retinol binding protein(RBP),microalbumin(MA),creatinine(Cr)and microalbumin to creatinine ratio(MA/Cr)in early diabetic nephropathy.Methods Fifty patients with early diabetic nephropathy admitted to the First People's Hospital of Zhaoqing City from February 2022 to February 2024 were selected as research subjects and included in observation group.In addition,50 patients with simple diabetes mellitus during the same period were selected as control group.After admission,the levels of urine RBP,MA and Cr in all patients were detected using automatic specific protein analyzer,MA/Cr was calculated,and the differences of above indicators between two groups were compared.The receiver operator characteristic curve(ROC curve)was drawn to evaluate the diagnostic value of RBP,MA,Cr,MA/Cr alone and in combination for early diabetic nephropathy.Results The levels of MA and MA/Cr in observation group were significantly higher than those in control group[MA(mg/L):376.42±79.39 vs.10.95±2.20;MA/Cr(g/mol):79.55±19.38 vs.1.58±0.30;both P<0.05],while no significant differences were observed in RBP or Cr levels between two groups[RBP(mg/L):3.97±0.96 vs.2.51±0.96;Cr(mmol/L):8.41±0.94 vs.7.88±0.78;both P>0.05].The area under ROC curve(AUC)of combined detection of urine RBP,MA,Cr and MA/Cr in diagnosis of early diabetic nephropathy was 0.960,and the sensitivity and specificity were 90.00%and 98.00%,respectively.The diagnostic value of combined detection was better than those of RBP and Cr alone.Conclusions The levels of urine MA and MA/Cr in patients with early diabetic nephropathy were significantly higher than those in patients with simple diabetes mellitus,but the levels of RBP and Cr do not change significantly.The combined detection of urine RBP,MA,Cr and MA/Cr has high specificity in the diagnosis of early diabetic nephropathy,but has little overall advantage compared with detection of MA and MA/Cr alone.
作者
冼颖仪
叶锦华
帅虎
刘健
Xian Yingyi;Ye Jinhua;Shuai Hu;Liu Jian(Department of Laboratory Medicine,the First People's Hospital of Zhaoqing City,Zhaoqing 526000,Guangdong,China)
出处
《实用检验医师杂志》
2025年第3期219-222,共4页
Chinese Journal of Clinical Pathologist
