CAJ | 학술논문

目的：探讨同型半胱氨酸（Hcy）、基质金属蛋白酶-2（MMP-2）和糖化血红蛋白（HbAlc）联合检测在糖尿病肾病（ DN）中早期诊断中的应用价值。方法将103例DN患者根据尿白蛋白排泄率（ UAER）分为无白蛋白尿组、微量白蛋白尿组和临床白蛋白尿组，另取同期门诊的健康体检者37例作为对照组，比较4组间Hcy、MMP-2和HbAlc水平的变化，应用Pearson's相关性分析和ROC曲线对各指标进行评价。结果 DN组患者Hcy和HbAlc水平明显升高， MMP-2水平明显降低，与对照组相比差异有统计学意义（ P <0.05），且微量白蛋白尿组和临床白蛋白尿组与无蛋白尿组差异存在统计学意义（ P <0.05）；DN患者的Hcy、MMP-2和HbAlc水平与UAER呈显著正相关（ r =0.77、0.56、0.63，P <0.05）；Hcy、MMP-2和HbAlc联合检测的灵敏度、特异度和检出率均高于各独立指标。结论 Hcy、MMP-2和HbAlc联合检测对DN患者早期肾功能的损伤较为敏感，在预防、延缓DN中有重要的临床价值。
목적：탐토동형반광안산（Hcy）、기질금속단백매-2（MMP-2）화당화혈홍단백（HbAlc）연합검측재당뇨병신병（ DN）중조기진단중적응용개치。방법장103례DN환자근거뇨백단백배설솔（ UAER）분위무백단백뇨조、미량백단백뇨조화림상백단백뇨조，령취동기문진적건강체검자37례작위대조조，비교4조간Hcy、MMP-2화HbAlc수평적변화，응용Pearson's상관성분석화ROC곡선대각지표진행평개。결과 DN조환자Hcy화HbAlc수평명현승고， MMP-2수평명현강저，여대조조상비차이유통계학의의（ P <0.05），차미량백단백뇨조화림상백단백뇨조여무단백뇨조차이존재통계학의의（ P <0.05）；DN환자적Hcy、MMP-2화HbAlc수평여UAER정현저정상관（ r =0.77、0.56、0.63，P <0.05）；Hcy、MMP-2화HbAlc연합검측적령민도、특이도화검출솔균고우각독립지표。결론 Hcy、MMP-2화HbAlc연합검측대DN환자조기신공능적손상교위민감，재예방、연완DN중유중요적림상개치。
Objective To explore the significance of levels of homocysteine(Hcy),matrix metalloproteinase-2(MMP-2)and glyco-sylated hemoglobin( HbAlc)in early diagnosis of patients with diabetic nephropathy. Methods A total of 103 patients with diabetes nephropathy were divided into albuminuria-free group,microalbuminuria group and clinical albuminuria group,and 37 healthy persons from department of healthy physical examination were selected as control group. The levels of Hcy,MMP-2 and HbAlc were examined and compared with those of control group,and all these indicators were evaluated by Pearson 's Correlation Analysis and ROC curve analysis. Results Levels of Hcy and HbAlc in patients with diabetic nephropathy group were significantly increased,and level of MMP-2 was decreased in this group,and the differ-ence was significant in comparison with those of control group( P <0. 05),and the difference in microalbuminuria group and clinical albuminuria group was also statistically significant( P <0. 05)in comparison with those of control group. In patients with diabetic nephropathy,levels of Hcy, MMP-2 and HbAlc were positively correlated with UAER( r =0. 77,0. 56,0. 63,P <0. 05). The sensitivity,specificity and detection rate of joint detection were higher than those with individual detection of indicators. Conclusion The joint detection of levels of Hcy,MMP-2 and HbAlc is more sensitive in early detection of renal impairment in patients with diabetic nephropathy,and it has important clinical value in preven-tion and delaying the occurrence of diabetic nephropathy.