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目的探讨B型钠尿肽(BNP)、肾小球滤过率(e GFR)在诊断2型糖尿病肾病病变程度中的价值及临床意义。方法选择2型糖尿病患者137例及健康对照组50例,检测其血浆BNP、血清肌酐(Scr)以及24 h尿白蛋白排泄率(UAER),按照UAER将糖尿病患者分为:正常蛋白尿组(NA组)50例、微量蛋白尿组(MA组)51例、临床蛋白尿组(CP组)36例,并对检测结果进行统计学分析。结果 MA组和CP组BNP水平均显著高于NC组及NA组,糖尿病患者BNP随UAER增加而增加,呈正相关(r=0.724,P<0.01);CP组e GFR显著低于其他3组,差异有统计学意义(P<0.05),e GFR与UAER呈负相关(r=-0.609,P<0.01);ROC曲线分析,BNP曲线下面积为0.782,cut-off值为61.65 pg/ml,灵敏度为67.81%,特异度为70.00%,准确度为68.61%;而e GFR曲线下面积为0.223。结论糖尿病肾病患者血浆BNP水平明显升高,对2型糖尿病肾病的诊断具有一定价值;e GFR随2型糖尿病肾病病情发展而降低,但不适合作为2型糖尿病肾病的早期诊断指标。
Objective To investigate the value and clinical significance of B-type natriuretic peptide (BNP) and glomerular filtration rate (e GFR) in the diagnosis of type 2 diabetic nephropathy. Methods 137 patients with type 2 diabetes mellitus and 50 healthy controls were enrolled in this study. Plasma BNP, serum creatinine (Scr) and 24 h urinary albumin excretion (UAER) were measured. According to UAER, patients with diabetes were divided into normal proteinuria group NA group), 50 cases of microalbuminuria group (MA group) and 36 cases of clinical proteinuria group (CP group), and the results were statistically analyzed. Results The levels of BNP in both MA and CP groups were significantly higher than those in NC and NA groups. BNP increased with the increase of UAER in diabetic patients (r = 0.724, P <0.01) (R = -0.609, P <0.01). The area under the curve of BNP was 0.782, the cut-off value was 61.65 pg / ml, the difference was statistically significant (P < The sensitivity was 67.81%, the specificity was 70.00%, and the accuracy was 68.61%. The area under the eGFR curve was 0.223. Conclusions Plasma BNP levels are significantly elevated in patients with diabetic nephropathy, which is of value in the diagnosis of type 2 diabetic nephropathy. E GFR is decreased with the development of type 2 diabetic nephropathy, but it is not suitable as an early diagnostic indicator of type 2 diabetic nephropathy.