自身抗体联合检测对糖尿病肾病诊断的应用价值

摘要

目的：探讨联合检测抗心磷脂抗体（ACLA）、抗中性粒细胞胞浆抗体（ANCA）、抗肾小球基底膜（GBM）抗体及 C 反应蛋白（CRP）、胱抑素 C（Cys C）、微量白蛋白（mAlb）在糖尿病肾病诊断中的应用价值，为糖尿病肾病的临床诊断和治疗提供依据。方法收集56例糖尿病肾病（DN）患者血清标本作为糖尿病肾病组、40例健康人血清作为对照组。采用 ELISA 法检测标本血清中 ACLA，采用 IIF 法检测 ANCA 和抗 GBM 抗体，采用免疫比浊法测定 CRP、Cys C 和 mAlb。结果进行统计学分析。结果糖尿病肾病组血清中 ACLA 和 ANCA 的阳性率较对照组显著增高（P ＜0．01），抗 GBM 抗体的阳性率也较对照组明显增高（P ＜0．05）；DN 组 CRP、Cys C 和 U-mAlb 的水平较非 DN 组均明显增高，两组有显著性差异（P ＜0．01）；联合检测 ACLA、ANCA 和抗 GBM 抗体的阳性率较单独检测明显升高（P ＜0．05或 P ＜0．01）。结论联合检测血清中 ACLA、ANCA 和抗 GBM 抗体可提高糖尿病肾病诊断的阳性率，对糖尿病肾病的诊断具有重要应用价值。%Objective To discuss application value of combined detection of anti-cardiolipin antibodies (ACLA),an-tineutr-ophil cytoplasmic antibodies (ANCA),anti-glomerular basement membrane (GBM)antibodies and the level of C-reactive protein (CRP),Cystatin C(Cys C),urine albumin(mAlb)in patients with diabetic nephropathy (DN)on the diagnosis of diabetic nephropathy,in order to provide references for diagnosis and treatment of diabetic nephropathy. Methods 56 cases of DN patients serum (as diabetic nephropathy group),and 40 cases of healthy people serum (as the control group)were collected.ACLA in serum was detected by ELISA,ANCA and anti-GBM antibodies were detected by IIF,and the levels of CRP,Cys C and mAlb were measured by immunoturbidimetry.Then,the positive rate of ACLA,ANCA and anti-GBM antibodies and the correlation of serum levels of CRP,Cys C and mAlb with DN were an-alyzed statistically.Results The positive rate of ACLA and ANCA in serum of diabetic nephropathy group?is signifi-cantly higher than that in control group(P <0.01)and the positive rate of anti-GBM antibodies in DN patients also in-creased obviously (P <0.05);The levels of Cys C,mAlb and CRP are all significantly higher in DN patients than that in control group (P <0.01);The positive rate of combined detection of ACLA,ANCA and anti-GBM antibodies in DN was higher than that of detection alone (P <0.05 or P <0.01).Conclusion The combined detection of serum ACLA, ANCA and anti-GBM antibodies can improve positive rate and has important application value for diagnosis of diabetic nephropathy.