尿白蛋白/尿肌酐与 α1微球蛋白及C反应蛋白对早期糖尿病肾病的诊断价值

摘要

Objective To investigate the diagnostic value of urinary albumin/urinary creatinine(UAlb/UCr), α1-microglobulin(α1-MG)and C-reactive protein(CRP)in patients with early diabetic nephropathy.Methods 139 patients with suspected DN were enrolled in this study.Urinary albumin/urinary creatinine(UAlb/UCr),α1-microglob-ulin(α1-MG)and C-reactive protein(CRP)of the patients were measured by immunoturbidimetry assay.The single di-agnosis and the joint diagnosis of DN were compared with the final pathological diagnosis.Results The pathological di-agnosis of 139 cases of suspected patients showed that 136 cases were positive and 3 cases were negative.We choose the pathological diagnosis as gold standard.The sensitivity,specificity,accuracy,positive predictive value and negative pre-dictive value of the joint diagnosis by the three indexes were 99.26%,66.67%,98.56%,99.26%,66.67% respec-tively,of which the sensitivity,specificity,accuracy higher than the single diagnosis by UAlb/UCr,α1-MG or CRP.Con-clusion The joint diagnosis by UAlb/UCr,α1-MG and CRP has important significance for early diagnosis of DN,which shows high sensitivity and accuracy and can be used as effective screening method.%目的 探讨尿白蛋白/尿肌酐(UAlb/UCr)、α1微球蛋白(α1-MG)、C反应蛋白(CRP)对早期糖尿病肾病(DN)的诊断价值.方法 选取疑似DN的患者139例,经免疫散/透射比浊法检测UAlb/UCr、α1-MG及CRP水平,以最终的病理诊断为金标准,对单项诊断与联合诊断DN的结果进行比较.结果 最终病理诊断139例的结果显示:阳性136例,阴性3例.以该诊断结果为金标准.三者联合诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为99.26%、66.67%、98.56%、99.26%、66.67%,其灵敏度、特异度、准确度均高于UAlb/UCr、α1-MG、CRP单项诊断.结论 UAlb/UCr、α1-MG、CRP联合诊断对糖尿病早期肾病诊断有重要意义,联合检测的诊断灵敏度、准确度高,可作为临床早期DN的有效筛选方法.