初诊2型糖尿病患者尿PCX和Nephrin及单核细胞趋化蛋白-1联合检测对早期糖尿病肾病的预测价值

目的:通过对初诊2型糖尿病患者尿PCX,Nephrin及单核细胞趋化蛋白-1(MCP-1)进行检测,探讨三者对早期糖尿病肾病的预测价值。方法:选择2011年5月—2011年12月住院初诊2型糖尿病患者132例,正常对照(N)组36例,尿白蛋白/尿肌酐(UAlb/UCR)<30 mg/g为糖尿病(DM)组56例,UAlb/UCR≥30 mg/g为糖尿病肾病(DN)组76例。检测尿PCX(UPCX),Nephrin(UNephrin),MCP-1(UMCP-1),白蛋白(UAlb)及尿肌酐(UCR)。比较各组UPCX/UCR,UNephrin/UCR,UMCP-1/UCR的差异及2型糖尿病患者上述各指标间的相关性及与UAlb/UCR的相关性,计算糖尿病患者UMCP-1/UCR,UNephrin/UCR,UPCX/UCR及三者联合检测的阳性率,并与UAlb/UCR的阳性率进行比较分析。结果:UPCX/UCR,UMCP-1/UCR水平糖尿病组分别为(37.37±22.83)μg/g和(47.19±29.98)ng/g,比正常对照组明显升高(P<0.05);UAlb/UCR,UPCX/UCR和UMCP-1/UCR水平DN组比DM组和正常对照组明显升高(P<0.05);UNephrin/UCR水平DN组较DM组明显升高(P<0.05)。2型糖尿病患者UPCX/UCR,UMCP-1/UCR和UNephrin/UCR水平与UAlb/UCR呈正相关(r=0.619;0.568;0.535)(P<0.05);UPCX/UCR水平与UMCP-1/UCR和UNephrin/UCR呈正相关(r=0.799;0.718)(P<0.05),UNephrin/UCR水平与UMCP-1/UCR水平呈正相关(r=0.635,P<0.05);UMCP-1/UCR,UNephrin/UCR and UPCX/UCR的阳性率较UAlb/UCR显著升高(χ2=9.818,6.673,5.395,P<0.05)。结论:尿PCX,Nephrin和MCP-1单独或联合检测在早期糖尿病肾病诊断中具有重要的应用价值。

The predictive value of combined detecting urine PCX,Nephrin and MCP1 for diabetic nephropathy in newly diagnosed T2DM patients

Objective:To explore the predictive value of detect urinary PCX,Nephrin and MCP-1(MCP-1) for diabetic nephropathy in newly diagnosed type 2 diabetic patients.Methods:One hundred and thirty-two newly diagnosed T2DM patients from May to November in 2011.36 cases in control group,cases of urine albumin/creatinine in urine(UAlb/UCR)<30 mg/g in diabetes mellitus(DM group),cases of cases of UAlb/UCR≥30 mg/g in diabetic nephropathy(DN group).The urinary PCX(UPCX),Nephrin(UNephrin) MCP-1(UMCP-1),UAlb and UCR were measured.To compare the difference of UPCX/UCR,UNephrin/UCR,UMCP-1/UCR in every group,the pertinency of these index of T2DM patients and UAlb/UCR.The comparison among positive rate of UMCP-1/UCR,UNephrin/UCR,UPCX/UCR and UAlb/UCR were investigated in T2DM patients.Results:The UPCX/UCR,UMCP-1/UCR level were significantly higher in DM group than in healthy subjects(P<0.05).The UAlb/UCR,UPCX/UCR and UMCP-1/UCR were significantly higher in DN group than in DM group and in control group(P<0.05);the UNephrin/UCR level was significantly higher in DN than in DM(P<0.05).The UPCX/UCR,UMCP-1/UCR and UNephrin/UCR level was positively correlated with UAlb/UCR(r=0.619,0.568 and 0.535 respectively)(P<0.05) in T2DM patients.The UPCX/UCR level was positively correlated with UMCP-1/UCR and UNephrin/UCR levels(r=0.799 and 0.718 respectively)(P<0.05).The UNephrin/UCR level was positively correlated with UMCP-1/UCR level(r=0.635,P<0.05)in T2DM patients.The positive rate of UMCP-1/UCR,UNephrin/UCR and UPCX/UCR were significantly higher than that of UAlb/UCR(χ2=9.818,6.673 and 5.395 respectively,P<0.05) in T2DM patients.Conclusion:Urinary PCX,Nephrin and MCP-1 can act as predictors of the early renal damage in newly diagnosed type 2 diabetic patients.