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目的探讨早期糖尿病肾病(diabetic nephoropathy,DN)患者血清中性粒细胞明胶酶相关脂质运载蛋白(neu-trophil gelatinase-associated lipocalin,NGAL)与超敏C反应蛋白(high-sensitivity C-reaction protein,hs-CRP)、血清胱抑素C(cystatian C,Cys C)、尿白蛋白(urine-microalbumin,U-m ALB)的改变及其对DN早期诊断的临床意义。方法将2型糖尿病(type 2 diabetes mellitus,T2DM)患者156例按尿液清蛋白排泄率(urinary albumin excretion rate,UAER)分为三组:单纯糖尿病组(NA组)、早期肾病组(MA组)、临床肾病组(CN组);同时采用50例健康体检者作为正常对照组(NC组)。通过采用酶联免疫吸附法(ELISA)检测各组血中的NGAL浓度,乳胶增强免疫比浊法检测hs-CRP,免疫速率散射比浊法检测Cys C,化学发光法检测U-m ALB。对检测数据采用SPSS统计软件进行统计学分析。结果血清NGAL NA组、MA组、CN组显著高于NC组,差异有统计学意义(P<0.05);但MA组与CN组间比较,差异无统计学意义(P>0.05)。与NC组比较,NA组、MA组、CN组hs-CRP、Cys C、U-m ALB水平显著升高,差异有统计学意义(P<0.01)。血清NGAL与hsCRP、Cys C、U-m ALB均呈正相关(R2=0.281 1、0.180 9、0.858 0,P<0.001)。结论 T2DM早期肾损伤血清NGAL水平升高迅速,是临床诊断早期DN敏感而准确的指标,血清NGAL联合hs-CRP、Cys C、U-m ALB检测具有较高的临床诊断价值。
Objective To investigate the correlation between serum neutrophil gelatinase-associated lipocalin (NGAL) and high-sensitivity C-reaction protein (nAChR) in patients with early diabetic nephropathy (DN) hs-CRP, cystatian C (Cys C), urine microalbumin (Um ALB) and their clinical significance in the early diagnosis of DN. Methods 156 patients with type 2 diabetes mellitus (T2DM) were divided into three groups according to the urinary albumin excretion rate (UAER): simple diabetic group (NA group), early renal disease group (MA group ), Clinical nephropathy group (CN group). Meanwhile, 50 healthy subjects were used as normal control group (NC group). The concentration of NGAL in each group was detected by enzyme-linked immunosorbent assay (ELISA), the hs-CRP was detected by latex enhanced turbidimetry, the immunostaining nephelometry was used to detect Cys C, and the chemiluminescence method was used to detect U-m ALB. The test data using SPSS statistical software for statistical analysis. Results The levels of serum NGAL NA, MA and CN were significantly higher than those of NC (P <0.05). However, there was no significant difference between the two groups (P> 0.05). Compared with NC group, the levels of hs-CRP, Cys C and U-m ALB in NA group, MA group and CN group were significantly increased (P <0.01). Serum NGAL was positively correlated with hsCRP, Cys C and U-m ALB (R2 = 0.281 1, 0.180 9, 0.858 0, P <0.001). Conclusion Serum NGAL levels in early stage of renal injury in T2DM increase rapidly, which is a sensitive and accurate indicator of early DN in clinical diagnosis. Serum NGAL combined with hs-CRP, Cys C and U-m ALB detection have high clinical diagnostic value.