CAJ | 학술논문

目的：探讨肾损伤标志物肾损伤分子1(Kim-1)、热休克蛋白72(Hsp72)、人纤溶酶原激活物抑制因子1(PAI-1)、人中性粒细胞明胶酶相关脂质运载蛋白(NGAL)联合检测在2型糖尿病肾损伤早期诊断中的价值。方法将187例临床确诊为2型糖尿病的患者根据尿蛋白4项,即尿微量清蛋白(MA)、尿转铁蛋白(TRU)、尿免疫球蛋白(IGU)、尿α1-微球蛋白(A1M)结果分成尿蛋白阴性组(A 组)48例和尿蛋白阳性组(B 组,至少有一项尿蛋白阳性)139例；50例尿蛋白阴性的健康体检者为健康对照组(NC 组),对各组分别测定其晨尿中 Kim-1、Hsp72、PAI-1、NGAL 的水平。MA、TRU、IGU、A1M 采用速率散射比浊法；Kim-1、Hsp72、PAI-1和 NGAL 采用 ELISA 法。结果A 组患者尿中 Kim-1、Hsp72和 PAI-1水平与 NC 组比较差异有统计学意义(P <0.01),NGAL 的水平变化差异无统计学意义(P >0.5)；B 组 Kim-1、Hsp72、PAI-1、NGAL 各指标的水平均明显高于 NC 组(P <0.01),并且 B 组与 A 组相比,各项指标升高更明显(P <0.01)。Kim-1、Hsp72、PAI-1、NGAL 4项指标联合检测阳性率高于单项检测(P <0.01),在 A 组的阳性率为66.70%。结论2型糖尿病患者尿中 Kim-1、Hsp72、PAI-1、NGAL 在尿蛋白出现前就已出现明显异常,且这种异常变化随肾损伤程度的加重而明显；Kim-1、Hsp72、PAI-1、NGAL 可作为2型糖尿病肾损伤早期的标志物,联合检测阳性率明显高于单项检测,极大地提高了阳性检出率。
목적：탐토신손상표지물신손상분자1(Kim-1)、열휴극단백72(Hsp72)、인섬용매원격활물억제인자1(PAI-1)、인중성립세포명효매상관지질운재단백(NGAL)연합검측재2형당뇨병신손상조기진단중적개치。방법장187례림상학진위2형당뇨병적환자근거뇨단백4항,즉뇨미량청단백(MA)、뇨전철단백(TRU)、뇨면역구단백(IGU)、뇨α1-미구단백(A1M)결과분성뇨단백음성조(A 조)48례화뇨단백양성조(B 조,지소유일항뇨단백양성)139례；50례뇨단백음성적건강체검자위건강대조조(NC 조),대각조분별측정기신뇨중 Kim-1、Hsp72、PAI-1、NGAL 적수평。MA、TRU、IGU、A1M 채용속솔산사비탁법；Kim-1、Hsp72、PAI-1화 NGAL 채용 ELISA 법。결과A 조환자뇨중 Kim-1、Hsp72화 PAI-1수평여 NC 조비교차이유통계학의의(P <0.01),NGAL 적수평변화차이무통계학의의(P >0.5)；B 조 Kim-1、Hsp72、PAI-1、NGAL 각지표적수평균명현고우 NC 조(P <0.01),병차 B 조여 A 조상비,각항지표승고경명현(P <0.01)。Kim-1、Hsp72、PAI-1、NGAL 4항지표연합검측양성솔고우단항검측(P <0.01),재 A 조적양성솔위66.70%。결론2형당뇨병환자뇨중 Kim-1、Hsp72、PAI-1、NGAL 재뇨단백출현전취이출현명현이상,차저충이상변화수신손상정도적가중이명현；Kim-1、Hsp72、PAI-1、NGAL 가작위2형당뇨병신손상조기적표지물,연합검측양성솔명현고우단항검측,겁대지제고료양성검출솔。
Objective To explore the diagnosis value of urinary molecular markers of Kidney injury molecule 1(Kim-1),heat shock protein 72(Hsp72),plasminogen activator inhibitor 1(PAI-1),neutrophil gelatinase associated lipocalin(NGAL)joint detec-tion in the diagnosis of early type 2 diabetes renal damage.Methods Totally 187 cases of type 2 diabetes mellitus patients were sep-arate into two groups based on combination of four urine proteins[Microalbumin(MA),urinary transferrin(TRU),urine immuno-globulin(IGU),urine alpha 1 microglobulin (A1M)].Group A had 48 cases,and the urine protein of patients were negative.Group B had 139 cases,and the urine protein of patients were positive.The normal control group(NC group)selected 50 cases of urinary protein negative healthy people.MA,TRU,IGU,A1M were detected by rate scattering turbidimetric method,and Kim-1,Hsp72, PAI-1and NGAL were detected by enzyme-linked immunosorbent.Results Compared with NC group,the levels of urine Kim-1, Hsp72 and PAI-1 had significant increase in group A(P <0.01),but the variation in content of NGAL had no statistical significance (P >0.5).The levels of Kim-1,Hsp72,PAI-1 and NGAL significantly increased in group B(P <0.01),and the increase value was more significantly in group B(P <0.01).The positive rates l of Kim-1,Hsp72,PAI-1 and NGAL joint detection reached 66.70% in group A,which was significantly higher than single detection(P <0.01 ).Conclusion The levels of Hsp72,PAI-1,Kim-1 NGAL protein have been a significant exception before urinary protein in type 2 diabetes mellitus patients,and the abnormal is obvious with the increase of renal damage degree.Kim-1,Hsp72,PAI-1,NGAL can be used as early biomarkers of kidney injury in type 2 diabe-tes,the joint detection will greatly increase the positive detection rate.