血清NT-pro-BNP与Hcy联合检测对糖尿病肾病早期诊断价值

目的：观察联合检测血清NT-pro-BNP和血清同型半胱氨酸（Hcy）在糖尿病肾病早期诊断中的价值。方法：80例糖尿病患者根据UAER分为无蛋白尿组,微量蛋白尿组和临床蛋白尿组,30例健康体检者为对照组,采用酶联免疫荧光法检测血清NT-pro-BNP,循环液相法检测血清Hcy,比较各组NT-pro-BNP和Hcy含量,分析单项检测和联合检测的灵敏度和特异度,计算单项检测和联合检测ROC曲线下面积。结果：微量蛋白尿组和临床蛋白尿组血清NT-pro-BNP和Hcy含量明显高于健康对照组及无蛋白尿组差异均有统计学意义（P＜0.05）,NT-pro-BNP和Hcy联合检测的特异度为74.1%,敏感度为94.6%,明显高于单项指标检测的特异度和敏感度,联合NT-pro-BNP和Hcy检测ROC曲线下面积0.922,明显高于单项检测指标的曲线下面积。结论：血清NT-pro-BNP与同型半胱氨酸联合检测较单一检测诊断价值高,能提高糖尿病肾病早期肾损害的诊断效果,值得临床进一步推广。

The value of combined detection of serum NT-pro-BNP and serum homocysteine (Hcy) in the early diagnosis of diabetic nephropathy

Objective: To observe the value of combined detection of serum NT-pro-BNP and serum homocysteine (Hcy) in the early diagnosis of diabetic nephropathy. Methods: According to UAER, 80 diabetic patients were divided into the non-proteinuria group, the microalbuminuria group and the clinical albuminuria group. 30 healthy people were taken as control group. NT-pro-BNP and Hcy were detected by enzyme-linked immunofluorescence assay and circulating liquid chromatography respectively. NT-pro-BNP and Hcy in each group were detected and analyzed. Sensitivity and specificity were calculated for single detection and combined detection of the area under the ROC curve. Results: The levels of NT-pro-BNP and Hcy in serum of the microalbuminuria group and the clinical albuminuria group were significantly higher than those of the healthy control group and the non-albuminuria group (P<0.05). The specificity and sensitivity of combined detection of NT-pro-BNP and Hcy were 74.1% and 94.6% respectively, which were significantly higher than those of single index detection. The area of the ROC curve detected with NT-pro-BNP and Hcy was 0.922, which was significantly higher than the area of the ROC curve. Conclusion: The combined detection of serum NT-pro-BNP and homocysteine has higher diagnostic value than single detection, and can improve the diagnostic effect of early renal damage in diabetic nephropathy, which is worthy of further clinical application.