乳胶凝集比浊法和速率散射比浊法检测超敏CRP在糖尿病肾病中的辅助诊断价值分析

摘要

Objective To evaluate the value of high-sensitivity C-reactive protein (hs-CRP)in the diagnosis of diabetic nephropathy (DN)detected by the emulsion agglutination turbidimetric assay and speed scattering turbidimetric assay.Methods Peripheral blood sampling was collected from patients with diabetes mellitus alone (DM group,n =28),DN patients (DN group,n =38)and healthy counterparts (control group,n =30).Serum concentration of hs-CRP among three groups was detected by emulsion agglutination tur-bidimetric assay and speed scattering turbidimetric assay.The application value of hs-CRP level detected by two assays in the diagnosis of DN was evaluated by the receiver operating characteristic (ROC)curve.Cystatin C (CysC)level was detected by the latex enhanced immunoturbidimetry method among three groups,and the application value of the combined detection of hs-CRP and CysC in the diagnosis of DN was evaluated by the ROC.Results Both two assays revealed that the serum level of hs-CRP and positive rate of hs-CRP in the DM and DN groups were significantly higher than those in the healthy control group (all P <0.05),and the serum level of hs-CRP and positive rate of hs-CRP in the DN group were considerably higher than those in the DM group (both P <0.05).The ROC curve analysis demonstrated that the sensitivity and specificity of the emul-sion agglutination turbidimetric assay were 82% and 89%,and 79% and 90% for the speed scattering turbidi-metric assay.The sensitivity and specificity of the combination of hs-CRP and CysC were 87% and 92%,high-er compared with those of hs-CRP alone.Conclusions Serum level of hs-CRP is of clinical significance for the diagnosis of DN.The emulsion agglutination turbidimetric assay is superior to the speed scattering turbidi-metric assay in the diagnostic performance of DN.Combined detection of hs-CRP and CysC contributes to im-proving the sensitivity and specificity in the diagnosis of DN.%目的：探讨乳胶凝集比浊法（乳胶法）和速率散射比浊法（速率法）检测超敏 CRP （hs-CRP）对糖尿病肾病（DN）的辅助诊断价值。方法收集单纯糖尿病患者28例（单纯糖尿病组）、DN 患者38例（DN 组）和30名健康人（健康对照组）的外周血标本，分别采用乳胶法和速率法检测3组血液标本的 hs-CRP 水平，应用受试者工作特征（ROC）曲线评价2种方法对 hs-CRP 在 DN患者的辅助诊断效能；同时使用胶乳增强免疫透射比浊法检测3组的血清胱抑素 C 水平，应用 ROC曲线评价 hs-CRP 和胱抑素 C 联合检测对 DN 患者的辅助诊断效能。结果乳胶法和速率法均显示， DN 组、单纯糖尿病组血 hs-CRP 水平、hs-CRP 阳性率均高于健康对照组（P 均＜0.05），且 DN 组血hs-CRP 水平、hs-CRP 阳性率均高于单纯糖尿病组（P 均＜0.05）。ROC 曲线显示，乳胶法检测 hs-CRP 的诊断敏感度（82％）和特异度（89％）均较高；而速率法敏感度较低（79％）、特异度较高（90％）；hs-CRP 和胱抑素 C 联合诊断的敏感度为87％、特异度为92％，均高于 hs-CRP 单一指标。结论hs-CRP 的检测对 DN 的诊断有重要临床意义，乳胶法检测 hs-CRP 对 DN 的诊断效能优于速率法，hs-CRP 和胱抑素 C 联合检测有助于提高对 DN 诊断的敏感度和特异度。