论文部分内容阅读
目的通过对不同时期糖尿病肾病(DN)患者血清和尿中转化生长因子(TGF-β1)的检测,探讨TGF-β1在DN早期诊断中的意义。方法根据24 h尿白蛋白排泄率(UAER)分为单纯糖尿病(DM)组(T1组)32例,早期DN组(T2组)41例和晚期DN组(T3组)13例,并与23例正常人(C1组)作比较。用双抗体夹心酶联免疫吸附法(ELISA)分别检测各组血清pTGF-β1和尿液中uTGF-β1水平,比较各组之间两项指标的差异,以正常组单侧95%的上限值(X±1.64S)为正常值高限,确定阳性判定标准,并以UAER为金标准,进行T1组和T2组的诊断性能评价。同时用相应方法检测各标本中尿微量白蛋白(mAlb),最后确定TGF-β1对DN早期诊断的价值。结果 T1、T2、T3组pTGF-β1、uTGF-β1、mAlb较C1组明显升高,差异有统计学意义(P<0.05)。相关分析显示pTGF-β1、uTGF-β1与UAER正相关,pTGF-β1和uTGF-β1的异常比UAER出现更早,检测pTGF-β1和uTGF-β1水平可作为早期发现DN的敏感指标之一,其中以uTGF-β1的临床灵敏度更高。结论 uTGF-β1联合尿mAlb能早期诊断DN,并提高诊断的性能。
Objective To explore the significance of TGF-β1 in the early diagnosis of DN by detecting the serum and urine transforming growth factor-β1 (TGF-β1) in patients with diabetic nephropathy (DN) in different periods. Methods Thirty-two cases of DM (T1 group), 41 cases of early DN group (T2 group) and 13 cases of DN group (T3 group) were divided into two groups according to 24-hour urinary albumin excretion rate (UAER) Cases of normal (C1 group) for comparison. Serum levels of pTGF-β1 and uTGF-β1 in urine were detected by enzyme-linked immunosorbent assay (ELISA). The differences of two indexes between the two groups were compared. The upper limit of 95% The value of (X ± 1.64S) is the high limit of normal value, and the positive judgment standard is determined. The diagnostic performance of T1 and T2 groups is evaluated with UAER as the gold standard. At the same time using the corresponding method to detect urinary albumin (mAlb) in each sample, and finally determine the value of TGF-β1 on the early diagnosis of DN. Results The levels of pTGF-β1, uTGF-β1 and mAlb in T1, T2 and T3 groups were significantly higher than those in C1 group (P <0.05). Correlation analysis showed that there was a positive correlation between pTGF-β1 and uTGF-β1 and UAER. The abnormalities of pTGF-β1 and uTGF-β1 were earlier than UAER. The detection of pTGF-β1 and uTGF- Among them, the clinical sensitivity of uTGF-β1 is higher. Conclusion uTGF-β1 combined with urine mAlb can early diagnosis of DN, and improve the diagnostic performance.