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目的探讨尿微量白蛋白/肌酐(ACR)、尿β_2-微球蛋白(β_2-MG)、尿视黄醇结合蛋白(RBP)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿α1-微球蛋白(α1-MG)及其联合测定在糖尿病肾病(DKD)早期诊断中的应用价值。方法收集83例糖尿病肾病早期患者(DKD组)和70例健康体检者(对照组)的尿液标本,测定所有受试者尿ACR、尿β_2-MG、尿RBP、尿NAG、尿α1-MG水平,并对结果进行统计学分析。结果与对照组比较,DKD组尿ACR、尿β_2-MG、尿RBP、尿NAG、尿α1-MG水平均升高且差异均有统计学意义(P均<0.01)。ROC曲线结果显示,尿ACR的AUC为0.916,尿β_2-MG的AUC为0.779,尿RBP的AUC为0.9,尿NAG的AUC为0.868,尿α1-MG的AUC为0.915;联合检测的AUC为0.989。5个指标联合检测的阳性率和灵敏度均高于各单独指标。结论尿ACR、尿β_2-MG、尿RBP、尿NAG、尿α1-MG的联合检测可以有效提高糖尿病肾病的早期检出率,值得临床推广。
Objective To investigate the effects of urinary albumin / creatinine (ACR), urinary β_2-microglobulin (β_2-MG), urinary retinol binding protein (RBP) and urine N-acetyl-β-D-glucosaminidase , Urinary α1-microglobulin (α1-MG) and their combination in the early diagnosis of diabetic nephropathy (DKD). Methods Urine samples from 83 patients with early stage of diabetic nephropathy (DKD group) and 70 healthy subjects (control group) were collected and urine ACR, urinary β_2-MG, urinary RBP, urinary NAG, urinary α1-MG Level, and the results were statistically analyzed. Results Compared with the control group, urinary ACR, urinary β_2-MG, urinary RBP, urinary NAG and urinary α1-MG in DKD group were significantly increased (all P <0.01). The AUC of urinary ACR was 0.916, the AUC of urinary β_2-MG was 0.779, the urinary RBP AUC was 0.9, the urinary NAG AUC was 0.868, and the urinary α1-MG AUC was 0.915. The AUC of combination test was 0.989 The positive rate and sensitivity of the combined detection of five indicators were higher than the individual indicators. Conclusions Combined detection of urinary ACR, urinary β_2-MG, urinary RBP, urinary NAG and urinary α1-MG can effectively improve the early detection rate of diabetic nephropathy and is worthy of clinical promotion.