血清NGAL与Cr,BUN,RBP,Cys-C联合检测在糖尿病肾病早期诊断中的应用

目的 探讨血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)与肌酐(Cr)、尿素(BUN)、视黄醇结合蛋白(RBP)、胱抑素C(Cys-C)联合检测在糖尿病早期肾脏损害中的临床应用价值。方法 选择116例经临床确诊的糖尿病患者,将其分为单纯糖尿病组、糖尿病并发肾病组和糖尿病并发肾衰组,同时选择100例健康查体者作为对照组。采用日立7170A全自动生化分析仪对各组血清NGAL与Cr,BUN,RBP和Cys-C进行检测,其检测数据经统计学分析处理。结果 各组NGAL,Cr,BUN,RBP和Cys-C水平检测结果中,单纯糖尿病组与正常对照组之间差异无统计学意义(t=0.812～1.402,均P>0.05); 糖尿病并发肾病组NGAL,Cr,BUN,RBP和Cys-C水平均高于正常对照组、单纯糖尿病组,差异具有统计学意义(t=2.131～2.326,均P<0.05); 糖尿病并发肾病组和糖尿病并发肾衰组血清NGAL水平明显高于正常对照组、单纯糖尿病组,差异具有统计学意义(t=2.913～3.011,均P<0.01)。各组Cr,BUN,RBP和Cys-C检测异常率方面,糖尿病并发肾病组异常率分别为53.1%,62.5%,71.8%和81.3%,均显著高于正常对照组和单纯糖尿病组,差异有统计学意义(χ²=9.682～13.625,P<0.01),但其幅度低于糖尿病并发肾病组的NGAL异常率(87.5%),特别是糖尿病并发肾病组Cr,BUN的异常率远低于NGAL的异常率(χ²=12.322～13.253,均P<0.01); 糖尿病并发肾衰组的NGAL,Cr,BUN,RBP和Cys-C异常率略有差异,无统计学意义(P>0.05)。结论 血清NGAL的检测在糖尿病肾病早期诊断中具有重要的意义,特别是联合肾功其它指标的检测为临床诊断糖尿病早期肾脏损害以及损害的程度提供重要依据。

Application of Combined Detection of Serum NGAL and Cr,BUN,RBP and Cys C in Early Diagnosis of Diabetic Nephropathy

Objective To investigate clinical application value of detectiing serum NGAL combined with Cr,BUN,RBP and Cys-C in diabeticpatients with early renal damage.Methods Selected 116 cases of diabetic patients diagnosed clinically,which could be divided into simple diabetes group,diabetic nephropathy group and diabetes with renal failure group,and while 100 cases of healthy persons was as normal control group.The serum NGAL,Cr,BUN,RBP and Cys-C in each group were determined with Hitachi 7170Aautomatic biochemical analyzer,and the measured data were processed by statistical analysis.Results In the detection results of serumNGAL,Cr,BUN,RBP and Cys-C in each group,the simple diabetes group and the normal control group were not statistically significant(t=0.812～1.402,P>0.05).The levels of NGAL,Cr,BUN,RBP and Cys-C in the diabetic nephropathy group were higher than the normal control group and the simple diabetes group,and the difference was statistically significant(t=2.131～2.326,P<0.05).The levels of serum NGAL in diabetic nephropathy group and diabetic with renalfailure group were significantly higher than that in normal control group and the simple diabetes group(t=2.913～3.011,P<0.01).In the positive ratesof Cr,BUN,RBP and Cys-C in each group,those of the diabetic nephropathy group were 53.1%,62.5%,71.8% and 81.3% respectively,and significantly higherthan the normal control group and the simple diabetic group(χ²=9.682～13.625,P<0.01),but lower than the positive rate of NGAL in diabetic nephropathy group(87.5%),especially,the rates of Cr,BUN in diabetic nephropathy group were far lower than the rate of NGAL(χ²=12.322～13.253,all P<0.01).The positiverates of the serum NGAL,Cr,BUN,RBP and Cys-C in the diabetes with renal failure groups had slight difference,but no statistical significance(P>0.05).Conclusion Detection of serum NGAL is of great significance for the early diagnosis of diabetic nephropathy,especially to provide an important basis for early renal damage and the degree of renal damage combined with other detection index of renal function.