| 孟莉,舒丽红,周振科,等.血清肾胺酶、尿调节素、可溶性尿激酶受体联合检测对糖尿病肾损伤早期诊断的价值分析[J].安徽医药,2024,28(1):148-153. |
| 血清肾胺酶、尿调节素、可溶性尿激酶受体联合检测对糖尿病肾损伤早期诊断的价值分析 |
| Analysis of the value of combined detection of serum renalase, uromodulin and soluble urokinase receptor in the early diagnosis of diabetic kidney injury |
| |
| DOI：10.3969/j.issn.1009-6469.2024.01.031 |
| 中文关键词: 糖尿病肾病 受体，尿激酶型纤溶酶原激活物 血尿素氮 肌酸酐 肾胺酶 尿调节素 |
| 英文关键词: Diabetic nephropathies Receptors, urokinase plasminogen activator Blood urea nitrogen Creatinine Renalase Uromodulin |
| 基金项目: |
|
| 摘要点击次数: 213 |
| 全文下载次数: 89 |
| 中文摘要: |
| 目的探究血清肾胺酶( RNLS)、尿调节素( UMOD)、可溶性尿激酶型纤溶酶原激活物受体( suPAR)联合检测对糖尿病肾损伤早期诊断的价值。方法选取 2020年 3月至 2021年 3月成都市第七人民医院收治的 61例糖尿病肾损伤病人为糖尿病肾损伤组，按 24 h尿白蛋白排泄率( UAER)分为早期糖尿病肾病组( 29例)和临床期糖尿病肾病组( 32例)，选取 66例糖尿病病人为单纯糖尿病组，另选取同期健康体检者 60例为对照组。收集病人的一般临床资料并比较，采用尿素酶法检测血清尿素(UREA)氧化酶法检测肌酐( Cr)和尿酸( UA)水平，采用酶联免疫吸附法( ELISA)检测血清 RNLS、UMOD、suPAR的水平。 Pearson相关，性分析 RNLS、UMOD、suPAR与 UREA、Cr、UA以及临床资料的关系。采用受试者操作特征( ROC)曲线分析血清 RNLS、UMOD、suPAR联合检测对糖尿病病人发生肾损伤的诊断价值。结果糖尿病肾损伤组、单纯糖尿病组三酰甘油、总胆固醇、空腹血糖、糖化血红蛋白及血清 UREA、Cr、UA、suPAR水平［(133.56±42.68)ng/L，(66.48±17.13)ng/L比( 34.15±8.26)ng/L］均显著高于对照组( P<0.05)估算肾小球滤过率( eGFR)及血清 RNLS［( 28.62±7.61)mg/L，(35.47±9.29)mg/L比( 42.81±13.24) mg/L］、 UMOD水平［( 64.28±16.8，2)g/L，(119.45±28.65)g/L比( 139.82±32.84)g/L］均显著低于对照组( P<0.05)；且糖尿病肾损伤组较单纯糖尿病组升高或下降幅度大( P<0.05)。糖尿病肾损伤组糖尿病病程显著高于单纯糖尿病组( P<0.05)，24 h尿蛋白显著高于单纯糖尿病组和对照组( P<0.05)。临床期糖尿病肾病组病人血清 RNLS［( 26.28±6.69)mg/L比( 31.18±8.34)mg/L］、 UMOD水平［(51.26±14.41)g/L比( 78.65±19.49)g/L］较早期糖尿病肾病组均显著降低( P<0.05)，suPAR水平［(151.96±48.03)ng/ L比( 113.27±36.81)ng/L］显著升高( P<0.05)。 RNLS、UMOD与 UREA、Cr、UA、三酰甘油、总胆固醇、空腹血糖、糖化血红蛋白、糖尿病病程及 24 h尿蛋白均呈负相关( P<0.05)与 eGFR呈正相关( P<0.05)； suPAR与 UREA、Cr、UA、三酰甘油、总胆固醇、空腹血糖、糖化血红蛋白、糖尿病病程及 24 h尿蛋白均，呈正相关( P<0.05)，与 eGFR呈负相关(P<0.05)。 ROC曲线分析结果显示，血清 RNLS、UMOD、suPAR三项联合的曲线下面积( AUC)0.88显著高于 RNLS、UMOD单项检测的 AUC(0.81、0.83)(P<0.05)，而与 suPAR AUC比较差异无统计学意义( P>0.05)。结论糖尿病肾损伤病人血清 RNLS、UMOD、suPAR水平呈异常表达，且三项联合检测对糖尿病病人发生肾损伤的诊断价值较高，值得临床推广应用。 |
| 英文摘要: |
| Objective To explore the value of combined detection of serum renalase (RNLS), uromodulin (UMOD), and soluble uroki- nase-type plasminogen activator receptor (suPAR) in the early diagnosis of diabetic kidney injury.Methods Sixty-one patients with di-abetic kidney injury admitted to Chengdu Seventh People's Hospital from March 2020 to March 2021 were selected as the diabetic kid-ney injury group. According to the 24 h urinary albumin excretion rate (UAER), they were assigned into early diabetic nephropathygroup (29 cases) and clinical diabetic nephropathy group (32 cases). Sixty-six patients with diabetes were selected as the simple diabe-tes group, and another 60 healthy persons with physical examination during the same period were selected as the control group. Thegeneral clinical data of the patients were collected and compared. Urease method was used to detect serum urea (UREA), oxidase meth-od was used to detect creatinine (Cr) and uric acid (UA), enzyme-linked immunosorbent assay (ELISA) was used to detect the levels ofserum RNLS, UMOD and suPAR. Pearson correlation was used to analyze the relationship between RNLS, UMOD, suPAR and UREA,Cr, UA, clinical data. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of the combined detec-tion of serum RNLS, UMOD, and suPAR for kidney injury in diabetic patients.Results The levels of triacylglycerols, total cholesterol,fasting blood glucose, glycosylated hemoglobin and serum UREA, Cr, UA, suPAR [(133.56±42.68)ng/L, (66.48±17.13)ng/L vs. (34.15±8.26) ng/L] in diabetes kidney injury group and simple diabetes group were significantly higher than those in the control group (P< 0.05), and the estimated glomerular filtration rate (eGFR) and serum RNLS [(28.62±7.61)mg/L, (35.47±9.29)mg/L vs. (42.81±13.24) mg/ L], UMOD levels [(64.28±16.82)g/L, (119.45±28.65)g/L vs. (139.82±32.84) g/L] were significantly lower than those in the control group (P<0.05); and the renal injury group of diabetes increased or decreased significantly compared with the simple diabetes group (P<0.05). The duration of diabetes in diabetes kidney injury group was significantly higher than that in diabetes group (P<0.05), and the 24 h uri- nary protein was significantly higher than that in diabetes group and control group (P<0.05). Compared with the early diabetic nephrop- athy group, the levels of serum RNLS [(26.28±6.69)mg/L vs. (31.18±8.34) mg/L] and UMOD [(51.26±14.41)g/L vs. (78.65±19.49) g/L] of patients in the clinical diabetic nephropathy group were significantly lower (P<0.05), and the level of suPAR [(151.96±48.03)ng/L vs. (113.27±36.81) ng/L] was significantly higher (P<0.05). RNLS and UMOD were negatively correlated with UREA, Cr, UA, triacylglyc-erols, total cholesterol, fasting blood glucose, glycosylated hemoglobin, the course of diabetes and 24 h urinary protein (P<0.05), and positively correlated with eGFR (P<0.05); suPAR was positively correlated with UREA, Cr, UA, triacylglycerols, total cholesterol, fast-ing blood glucose, glycosylated hemoglobin, the course of diabetes and 24 h urinary protein (P<0.05), and negatively correlated with eG- FR (P<0.05). ROC curve analysis results showed that the area under the curve (AUC) 0.88 of the combination of serum RNLS, UMOD,and suPAR was significantly higher than that of single detection of RNLS and UMOD (0.81, 0.83) (P<0.05), while compared with AUC of suPAR, the difference was not statistically significant (P>0.05).Conclusion The serum RNLS, UMOD, and suPAR levels of diabet-ic kidney injury patients are abnormally expressed, and the combined detection of the three items is of high diagnostic value for diabet-ic kidney injury, and it is worthy of clinical application. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
