CAJ | 학술논문

目的探讨糖尿病肾病(DN)患者血清NGAL、Cystatin C的改变及其对DN早期诊断的临床意义.方法选择2型糖尿病(T2DM)患者55例,根据尿清蛋白排泄率(UAER)分为3组,正常清蛋白尿(NA)组15例、微量清蛋白尿(MA)组17例、临床肾病(CN)组23例;同期选取非肾病患者15例作为对照组.应用ELISA法检测患者血清NGAL(sNGAL)水平,应用免疫速率散射比浊法检测Cystatin C水平,分析血清NGAL及Cystatin C水平与肾小球滤过率(GFR)之间的相关关系,应用受试者操作特征(ROC)曲线评价二者诊断DN的敏感度.结果 (1)MA组、CN组患者血清NGAL和Cystatin C水平均较对照组升高,差异有统计学意义(P＜0.05),其中CN组患者血清NGAL和Cystatin C水平最高[分别为(845.8±68.8)ng/ml 和(3.58±1.21)mg/L].(2)Pearson相关分析:糖尿病患者血清NGAL和Cystatin C水平与GFR均呈负相关(r值分别为-0.871和-0.792,P＜0.01),且血清NGAL与GFR的相关性更密切.(3)两组患者血清NGAL和Cystatin C ROC曲线下的面积分别为0.839和0.720.结论糖尿病患者血清NGAL与GFR有较好的相关性,NGAL是诊断早期DN敏感而准确的指标,有望用于临床监测.
목적 탐토당뇨병신병(DN)환자혈청NGAL、Cystatin C적개변급기대DN조기진단적림상의의.방법 선택2형당뇨병(T2DM)환자55례,근거뇨청단백배설솔(UAER)분위3조,정상청단백뇨(NA)조15례、미량청단백뇨(MA)조17례、림상신병(CN)조23례;동기선취비신병환자15례작위대조조.응용ELISA법검측환자혈청NGAL(sNGAL)수평,응용면역속솔산사비탁법검측Cystatin C수평,분석혈청NGAL급Cystatin C수평여신소구려과솔(GFR)지간적상관관계,응용수시자조작특정(ROC)곡선평개이자진단DN적민감도.결과 (1)MA조、CN조환자혈청NGAL화Cystatin C수평균교대조조승고,차이유통계학의의(P＜0.05),기중CN조환자혈청NGAL화Cystatin C수평최고[분별위(845.8±68.8)ng/ml 화(3.58±1.21)mg/L].(2)Pearson상관분석:당뇨병환자혈청NGAL화Cystatin C수평여GFR균정부상관(r치분별위-0.871화-0.792,P＜0.01),차혈청NGAL여GFR적상관성경밀절.(3)량조환자혈청NGAL화Cystatin C ROC곡선하적면적분별위0.839화0.720.결론 당뇨병환자혈청NGAL여GFR유교호적상관성,NGAL시진단조기DN민감이준학적지표,유망용우림상감측.
Objective To explore the clinical changes and diagnostic significance of serum neutrophil gelatinase-associated lipocalin(NGAL) and Cystatin C in patients with diabetic nephropathy(DN).Methods Fifty T2DM patients were divided,according to urinary albumin excretion rate (UAER),into groups NA (normal albuminuria,n=15),MA (microalbuminuria,n=17),CN (clinical nephropathy,n=23),and another 15 patients without nephropathy were chosen as control group.NGAL level was detected by ELISA,Cystatin C level by particle-enhanced nephelometric immunoassay (PENIA).The relationship of NGAL and Cystatin C to glomerular filtration rate (GFR) was analyzed and the sensitivities of NGAL and Cystatin C were evaluated by ROC curve in diagnosis of diabetic nephropathy.Results NGAL and Cystatin C were higher in DM patients than in control,the difference was significant (P＜0.05),and the highest in CN group (845.8±68.8 ng/ml,3.58±1.21 mg/L,respectively).Pearson correlation analysis showed that NGAL and Cystatin C levels were negatively correlated with GFR(r=-0.871,-0.792, respectively,P＜0.01),and NGAL closer with GFR.The areas under ROC curve were 0.839,0.720,respectively.Conclusion NGAL,having good correlation with GFR in DM patients,is a sensitive and accurate indicator in early diagnosis of DN and is expected to be used in clinical monitoring.