Objective:To explore the diagnostic value of combined detection of glycosylated hemoglobin (HbA1c), cystatin C(CysC), serum amyloid A(SAA) and retinol binding protein(RBP) in early diabetic nephropathy(DN). Methods:64 patients with early-stage DN(early DN group) and 60 patients with diabetes (control group) were selected. The levels of HbA1c, CysC, SAA, and RBP in the two groups were determined and compared. Results:The levels of HbA1c, CysC, SAA and RBP in early DN group were (8.55±1.63)%,(1.68±0.35)mg·L-1,(11.28±2.84)mg·L-1,(86.45±9.74)mg·L-1, respectively, which were significantly higher than those in the control group(P<0.05). The positive detection rates of HbA1c, CysC, SAA,RBP and the combination of four indicators in early DN group were 78.13%,70.31%,62.50%,67.19%,96.88%, which were significantly higher than those in the control group (P<0.05), and the positive detection rate of the combination of four indicators was significantly higher than that of the individual indicator in early DN group (P<0.05). The sensitivity and accuracy of the joint detection of the four indicators in early DN group were 96.88% and 92.74% respectively, which were significantly higher than those of the individual indicator (P<0.05). Conclusion:HbA1c, CysC, SAA, RBP are closely related to diabetic nephropathy, and joint detection is of great significance in the diagnosis of early renal damage. |
[1] 谈玲,李元宽.血清胱抑素C与视黄醇结合蛋白在糖尿病肾病诊断中的意义[J]. 检验医学与临床, 2017, 14(10):1460-1461.
[2] 孙毅宏,富丽萍.糖尿病肾病的治疗进展[J].医学综述,2015,21(17):3191-3193.
[3] 吴家斌,洪富源,杨国凯,等.血清CysC、RBP和尿TRF、mAlb检测在糖尿病肾病早期诊断中的意义[J].广西医科大学学报,2017,34(08):1153-1156.
[4] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2013年版)[J]. 中国糖尿病杂志, 2014, 30(10):893-942.
[5] 中华中医药学会肾病分会.糖尿病肾病诊断、辨证分型及疗效评定标准(试行方案)[J].上海中医药杂志, 2007, 41(7):7-8.
[6] 李香,王丽宏,傅雪莲,等.microRNA在糖尿病肾病中的作用[J].东南大学学报(医学版),2015,34(2):325-328.
[7] BHATTACHARJEE N,BARMA S,KONWAR N,et al.Mechanistic insight of diabetic nephropathy and its pharmacotherapeutic targets:A update[J].Eur J Pharmacol,2016,791(11):8-24.
[8] 刘敏杰,张晓平,谢春福,等.血清Hcy与CysC对早期2型糖尿病肾病的临床诊断价值分析[J].现代生物医学进展,2017,17(7):1360-1363.
[9] 姜爱凤,王以新,马立萍,等.尿微量清蛋白联合糖化血红蛋白在糖尿病肾病早期检测中的临床意义[J].中国全科医学,2016,19(S1):93-95.
[10] KIM S S,SONG S H,KIM I J,et al.Urinary cystatin C and tubular proteinuria predict progression of diabetic nephropathy[J].Diabetes Care,2013, 36(3):656-661.
[11] BARUTTA F,BRUNO G,GRIMALDI S,et al.Inflammation in diabetic nephropathy:moving toward clinical biomarkers and targets for treatment[J]. Endocrine,2015,48(3):730-742.
[12] 张如霖,王弘明,彭霞,等.血清淀粉样蛋白A、胱抑素C与尿白蛋白/肌酐比值联合检测在早期糖尿病肾病中的诊断价值[J].检验医学,2018,33(2):97-100.
[13] 黄小华,许金春,张伟,等.血清视黄醇结合蛋白及中性粒细胞明胶酶相关载脂蛋白在糖尿病肾病中的临床价值研究[J].中国卫生检验杂志,2017, 27(15):2181-2183. |