| 血清TLR-3，miR-181b及URBP联合检测在糖尿病肾病诊断及预后判断的价值研究 |
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| 引用本文： | 祁桠楠a,胡江伟b,武 亮c,高 倩b,周雨聪c,郑慧霄a.血清TLR-3，miR-181b及URBP联合检测在糖尿病肾病诊断及预后判断的价值研究[J].现代检验医学杂志,2022,0(2):37-41. |
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| 作者姓名： | 祁桠楠a 胡江伟b 武 亮c 高 倩b 周雨聪c 郑慧霄a |
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| 作者单位： | （邢台医学高等专科学校第二附属医院a. 体检中心;b. 内分泌科;c. 肾内科, 河北邢台 054000） |
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| 摘 要： | 目的 探讨Toll 样受体3（toll like receptor, TLR-3）、微RNA（micro RNA, miR）-181b 和尿视黄醇结合蛋白（urinary retinol binding-protein, URBP）联合检测在糖尿病肾病（DN）诊断及预后判断的价值。方法 选取2016 年12 月～ 2018年12 月邢台医学高等专科学校第二附属医院收治的115 例DN患者作为观察组，另选取同期96 例2 型糖尿病作为对照组。采用美国ABI 公司7900 实时荧光定量PCR 仪检测TLR-3，miR-181b 水平，采用BNP 特定蛋白分析仪以速率免疫散射比浊法检测URBP 水平，采用肾小管萎缩与间质纤维化（IFTA）、间质炎症和肾小球分级评分判断肾病理损伤程度，分析两组及观察组不同肾病理损伤程度患者血清TLR-3，miR-181b 及URBP 水平，分析上述指标与肾病理损伤相关性及对DN 的诊断价值，同时随访12 个月，分析上述指标与终末期肾病（end-stage renal disease, ESRD）的关系。结果 ①观察组URBP（4.12±1.24mg/L），血清TLR-3（0.86±0.27）和miR-181b（2.55±0.76）水平高于对照组（2.88±0.86mg/L，0.59±0.18 和1.79±0.54），差异有统计学意义（t=8.367，8.217，8.275，均P ＜ 0.05）。② URBP，血清TLR-3，miR-181b 与DN 患者间质炎症、IFTA 评分和肾小球分级呈正相关（r=0.676，0.654，0.692，均P ＜ 0.05；r=0.705，0.682，0.733，均P ＜ 0.05；r=0.699，0.713 和0.745，均P ＜ 0.05）。③ URBP，血清TLR-3 和miR-181b 及三者联合诊断DN的曲线下面积（AUC）分别为0.751，0.782，0.796 和0.880。④ URBP 和miR-181b 高表达者随访12 个月ESRD 发生率（40.74%，41.03%）高于低表达者（9.52%，12.50%），差异有统计学意义（χ2=7.210，6.626，均P ＜ 0.05）。结论 URBP，血清TLR-3，miR-181b 与DN 患者肾脏病理损伤程度有关。三者联合可作为判定DN 的生物学标志物，指导临床防治ESRD。
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| 关 键 词： | Toll样受体3 微RNA-181b 尿视黄醇结合蛋白 糖尿病肾病 终末期肾病 |
Value of Combined Detection of Serum TLR-3, miR-181b and URBP in Diagnosis and Prognosis of Diabetic Nephropathy |
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| QI Ya-nana,HU Jiang-weib,WU Liangc,GAO Qianb,ZHOU Yu-congc,ZHEN Hui-xiaoa.Value of Combined Detection of Serum TLR-3, miR-181b and URBP in Diagnosis and Prognosis of Diabetic Nephropathy[J].Journal of Modern Laboratory Medicine,2022,0(2):37-41. |
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| Authors: | QI Ya-nana HU Jiang-weib WU Liangc GAO Qianb ZHOU Yu-congc ZHEN Hui-xiaoa |
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| Affiliation: | （a.Physical Examination Center; b.Department of Endocrinology;c.Department of Nephrology, the Second Affiliated Hospital of Xingtai Medical College, Hebei Xingtai 054000,China） |
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| Abstract: | Objective To explore the value of combined detection of Toll like receptor 3 (TLR-3), micro RNA (miR)-181b and urinary retinol binding protein (URBP) in the diagnosis and prognosis of diabetic nephropathy (DN). Methods From December 2016 to December 2018, 115 patients with DN admitted to the Second Affiliated Hospital of Xingtai Medical College were selected as the observation group, and the other 96 cases of type 2 diabetes mellitus were selected as the control group. The levels of TLR-3 and miR-181b were detected by ABI 7900 real-time quantitative PCR, and the levels of URBP were detected by BNP specific protein analyzer. The levels of serum TLR-3, miR-181b and URBP in the two groups and the observation group with different degrees of renal pathological damage glomerular grading, renal tubular atrophy and interstitial fibrosis (IFTA) score, interstitial inflammation were analyzed. The correlation between the above indexes and renal pathological injury and the diagnostic value of DN were analyzed. The patients were followed up for 12 months to analyze the relationship between the above indexes and end-stage renal disease (ESRD). Results ① The levels of URBP (4.12±1.24mg/L) and serum TLR-3 (0.86± 0.27), miR-181b (2.55±0.76) of the observation group were higher than those of the control group (2.88±0.86mg/L ,0.59±0.18 and 1.79±0.54), the differences were statistically significant(t=8.367, 8.217 ，8.275, all P ＜ 0.05). ② URBP (r=0.676, 0.654，0.692, all P<0.05) and serum TLR-3 (r=0.705, 0.682, 0.733, all P<0.05), miR-181b ( r=0.699, 0.713, 0.745, all P<0.05) was positively correlated with interstitial inflammation, IFTA score, and glomerular grading in DN patients. ③ The area under the curve (AUC) of URBP, serum TLR-3 and miR-181b in alone and combined diagnosis of DN were 0.753, 0.782 and 0.880, respectively. ④The incidence of ESRD ( 40.74%, 41.03%) of high-expressing URBP and miR-181b was higher than that of low-expressing people during the 12-month follow-up (9.52%, 12.50%), the differences were statistically significant(χ2=7.210, 6.626, all P ＜ 0.05). Conclusion URBP, serum TLR-3 and mir-181b were related to the degree of renal pathological injury in patients with DN. The combination of the three can be used as a biomarker to determine DN and guide the clinical prevention and treatment of ESRD. |
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