CAJ | 학술논문

目的：探讨血清同型半胱氨酸（Hcy）、血清β2微球蛋白（Sβ2-MG）、尿β2微球蛋白（Uβ2-MG）、尿微量清蛋白（Um-Alb）联合检测在糖尿病肾病（DN）中的临床诊断价值。方法收集2型糖尿病患者230例，其中，无并发症患者100例（糖尿病组），DN患者130例（DN组），另选择50例健康者作为对照组。采用全自动生化分析仪检测血清 Hcy、肌酐，全自动化学发光仪检测Sβ2-MG、Uβ2-MG ，糖化血红蛋白仪检测糖化血红蛋白（GHbA1c）。比较血清 Hcy、Sβ2-MG、Uβ2-MG、UmAlb的阳性检出率，单项及联合检测的敏感性、特异性、准确性、阴性预测值及阳性预测值。结果 DN组患者血清 Hcy、GHbA1c、肌酐、Sβ2-MG、Uβ2-MG及UmAlb浓度均显著高于糖尿病组和对照组（P＜0．01）；糖尿病组患者血清肌酐浓度与对照组比较，差异无统计学意义（P＞0．05），其余指标的检测浓度均显著高于对照组（P＜0．05）。糖尿病组患者血清 Hcy、Sβ2-MG、Uβ2-MG、UmAlb联合检测的阳性检出率为23．00％；DN组患者4项指标联合检测的阳性检出率为95．38％，特异性、阳性预测值分别为84．67％、84．35％，敏感性、准确性、阴性预测值分别为95．38％、89．64％、95．49％。结论血清 Hcy、Sβ2-MG、Uβ2-MG、UmAlb联合检测对DN的早诊断具有重要价值。
목적：탐토혈청동형반광안산（Hcy）、혈청β2미구단백（Sβ2-MG）、뇨β2미구단백（Uβ2-MG）、뇨미량청단백（Um-Alb）연합검측재당뇨병신병（DN）중적림상진단개치。방법수집2형당뇨병환자230례，기중，무병발증환자100례（당뇨병조），DN환자130례（DN조），령선택50례건강자작위대조조。채용전자동생화분석의검측혈청 Hcy、기항，전자동화학발광의검측Sβ2-MG、Uβ2-MG ，당화혈홍단백의검측당화혈홍단백（GHbA1c）。비교혈청 Hcy、Sβ2-MG、Uβ2-MG、UmAlb적양성검출솔，단항급연합검측적민감성、특이성、준학성、음성예측치급양성예측치。결과 DN조환자혈청 Hcy、GHbA1c、기항、Sβ2-MG、Uβ2-MG급UmAlb농도균현저고우당뇨병조화대조조（P＜0．01）；당뇨병조환자혈청기항농도여대조조비교，차이무통계학의의（P＞0．05），기여지표적검측농도균현저고우대조조（P＜0．05）。당뇨병조환자혈청 Hcy、Sβ2-MG、Uβ2-MG、UmAlb연합검측적양성검출솔위23．00％；DN조환자4항지표연합검측적양성검출솔위95．38％，특이성、양성예측치분별위84．67％、84．35％，민감성、준학성、음성예측치분별위95．38％、89．64％、95．49％。결론혈청 Hcy、Sβ2-MG、Uβ2-MG、UmAlb연합검측대DN적조진단구유중요개치。
Objective To investigate the clinical diagnostic value of serum homocysteine (Hcy) ,serum beta 2-microglobulin(Sβ2-MG),urine beta 2-microglobulin(Uβ2-MG),urine microalbumin(UmAlb) combined detection for diabetic nephropathy (DN). Methods 230 cases of type 2 diabetes in which 100 patients without complications (diabetic group) ,130 patients with DN (DN group) were enrolled ,and another 50 healthy people served as control group .Automatic biochemical analyzer was employed to de-tect serum Hcy and creatinine ,automated chemiluminescence analyzer was used to detect Sβ2-MG and Uβ2-MG ,Glycated hemoglo-bin cytometry was adopted to measure glycosylated hemoglobin A 1c(GHbA1c) .Positive rates were compared among serum Hcy , Sβ2-MG ,Uβ2-MG ,UmAlb detection and sensitivity ,specificity ,accuracy ,positive predictive value and negative predictive value were compared between individual and joint detection .Results Serum Hcy ,GHbA1c ,creatinine ,Sβ2-MG ,Uβ2-MG and UmAlb concen-trations of patients in DN group were significantly higher than those in the diabetic group and the control group (P< 0 .01) . Difference of serum creatinine concentration showed no statistical significance between the diabetic group and the control group (P>0 .05) ,and differences of remaining indicators′concentration in the diabetic group were significantly higher than those in the control group(P<0 .05) .The positive rate of Hcy ,Sβ2-MG ,Uβ2-MG and UmAlb combined detection in the diabetic group was 23 .00% .In DN group ,the positive rate of the four indicators combined detection was 95 .38% ,with 84 .67% ,84 .35% for specificity and posi-tive predictive value ,respectively ,and 95 .38% ,89 .64% ,95 .49% for sensitivity ,accuracy and negative predictive values ,respective-ly .Conclusion Serum Hcy ,Sβ2-MG ,Uβ2-MG and UmAlb combined detection has important value for early diagnosis of DN .