血清视黄醇结合蛋白4在糖尿病肾病早期诊断中的临床价值

目的探讨血清视黄醇结合蛋白4(RBP4)在糖尿病早期肾功能损伤方面的临床诊断价值。方法根据尿清蛋白排泄率将确诊的232例糖尿病患者分为早期糖尿病肾病(DN)组、临床期DN组,治疗期DN组,单纯DN组,与60例健康对照者同时检测血清RBP4、胱抑素C(Cys-C)、尿素氮(BUN)、肌酐(Cr),并进行统计学处理(t检验和χ2检验)。结果早期DN组RBP4水平明显高于单纯DN组,差异具有统计学意义(t=6.704 3,P<0.01),与同期Cys-C检测结果呈正相关。而BUN、Cr检测结果与单纯DN组比较,差异无统计学意义(P>0.05)。早期DN组RBP4灵敏度比Cys-C、BUN和Cr指标的灵敏度高,RBP4阳性率早期DN组(62.1%)显著高于治疗期DN组(27.6%)(χ2=13.942 3,P<0.01)。结论血清RBP4是一种良好的检测早期肾功能损害的标志物,可作为糖尿病肾病早期诊治及疗效判断的定期筛选及监测指标。

Clinical value of serum retinol binding protein 4 in early diagnosis of diabetic nephropathy

Objective To discuss the clinical value of retinol binding protein 4（RBP4） in the diagnosis of early impairment of renal. Methods According to urinary albumin excretion rate in 232 patients with diabetes were divided into early DN group,clinical stage DN group,treatment period of DN group,simple DN group,and 60 healthy subjects,who were detected by serum RBP4,Cys-C,BUN,Cr and statistical analysis （t test and X2 test）. Results RBP4 level in the early DN group was significantly higher than the simple DN group,the difference was statistically signifi- cant （t= 6. 704 3, P〈0.01）, showing the positive correlation with the result of Cys-C test at the same period. There was no significant difference in the results of BUN and Cr tests between the early DN group and simple DN group（P〉0.05）. The sensitivity of RBP4 in early DN group was higher than that of Cys-C,BUN and Cr. The positive rate of RBP4 in early DN group（62.1%） was significantly higher than the one in treatment period of DN group （27.6%） （X2 =13. 942 3,P〈0.01）. Conclusion The serum RBP4 is a good biomarker to inspect the early impairment of renal, which can be treated as the index for the regular screening and monitoring of early diagnosis and judgment of cur- ative effect of diabetic nephropathy.