血清结合珠蛋白对2型糖尿病患者肾功能预测价值分析

摘要

目的：探讨血清结合珠蛋白水平对2型糖尿病患者早期肾功能下降的预测作用。方法选取2013年6月至2014年6月该院收治的2型糖尿病患者98例，按尿清蛋白排泄率（UAER）分为 A组（UAER：＜30 mg／24 h ，n＝36）、B组（UAER ：≥30～≤300 mg／24 h ，n＝32）和C组（UAER：＞300 mg／24 h ，n＝30），另选取30例同期健康体检者作为对照组。统计分析4组血清结合珠蛋白、尿微量清蛋白和尿β2‐微球蛋白、血清肌酐、血清尿素氮和血清胱抑素C（Cys C）水平，并分析血清结合珠蛋白水平与各肾功能指标的关系。结果对照组血清结合珠蛋白水平（70．48±14．87）m g／L ，低于A组、B组和C组的（124．48±24．15）、（153．41±26．74）、（206．54±30．55）m g／L ，对照组尿微量清蛋白水平、尿β2‐微球蛋白、血清肌酐、血清尿素氮和血清Cys C水平亦低于A组、B组和C组；A组血清结合珠蛋白水平、肾小球功能指标和肾功能指标低于B组和C组，且B组血清结合珠蛋白水平、肾小球功能指标和肾功能指标亦低于C组，差异有统计学意义（P＜0．05）。Pearson相关性分析结果显示，2型糖尿病患者血清结合珠蛋白水平与其尿微量清蛋白、尿β2‐微球蛋白、血清肌酐、血清尿素氮和血清Cys C水平均呈正相关（ r＝0．718、0．724、0．762、0．748、0．783，P＜0．05）。结论2型糖尿病患者可出现血清结合珠蛋白水平的升高且随着患者UAER等肾功能指标的升高其血清结合珠蛋白水平升高，其血清结合珠蛋白水平可用于患者肾功能下降的预测。%Objective To investigate the prediction value of serum haptoglobin(Hp) level on early decline of renal function in the patients with type 2 diabetes mellitus(T2DM ) .Methods 98 patients with T2DM in our hospital from June 2013 to June 2014 were selected and divided into group A(UAER<30 mg/24 h ,n=36) ,B(UAER 30-300 mg/24 h ,n=32) and C(UAER>300 mg/24 h ,n=30) according to urinary albumin excretion rate(UAER) . Contemporaneous 30 persons undergoing the healthy physical examination were selected as the control group .Serum Hp level ,urine microalbumin levels ,urine beta 2 microglobulin ,serum creatinine level ,serum urea nitrogen levels and serum cystatin C (Cys C) levels in the two groups were statistically analyzed and the relations between serum Hp level and each index of renal function were also analyzed .Results serum Hp level in the control group was (70 .48 ± 14 .87) mg/L ,which was lower than (124 .48 ± 24 .15) ,(153 .41 ± 26 .74) and (206 .54 ± 30 .55)mg/L in the group A ,B and C ;the urine micro albumin ,urine beta 2 microglobulin ,serum creatinine ,serum urea nitrogen and serum Cys C levels in the control group were also lower than those in the group A ,B and C ;serum Hp ,glomerular and renal function in the group A were lower than those in the group B and C ,and serum Hp ,glomerular and renal function levels in the group B were lower than those in the group C ,the differences were statistically significant(P<0 .05) . The Pearson correlation analysis results showed that serum Hp level in T2DM patients was positively correlated with urine microalbumin and urine beta 2 microglobulin levels ,serum creatinine ,serum urea nitrogen and serum Cys C lev‐els respectively(r=0 .718 ,0 .724 ,0 .718 ,0 .724 ,0 .783 ,P<0 .05) .Conclusion Serum Hp level in the patients with T2DM is increased and can be increased with the increase of urinary albumin excretion rate and other renal function indexes ,which means that serum Hp level can be used for predicting early renal function decline .