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目的探讨2型糖尿病患者尿液中血管细胞黏附分子-1(VCAM-1)水平与肾脏损伤的相关性及其临床意义。方法选取117例2型糖尿病患者和25例健康体检者(正常对照组),检测尿VCAM-1、尿微量白蛋白、血清肌酐的水平,计算糖尿病患者的肾小球滤过率(e GFR)。分析尿液VCAM-1与尿微量白蛋白、e GFR的相关性,ROC曲线评价VCAM-1在评估2型糖尿病患者肾脏损伤中的临床意义。结果糖尿病患者的VCAM-1水平高于正常对照组,差异有统计学意义(P<0.01);VCAM-1水平与e GFR呈负相关(r=-0.809,P<0.01);VCAM-1与尿微量白蛋白及血清肌酐均呈正相关(r值分别为0.812、0.758,P<0.01);VCAM-1诊断糖尿病肾病的AUC为0.951,临界值为38.26 ng/ml。结论检测糖尿病患者尿液VCAM-1水平对疾病诊断及病情判断具有一定的参考价值。
Objective To investigate the correlation between the level of vascular cell adhesion molecule-1 (VCAM-1) and renal damage in type 2 diabetic patients and its clinical significance. Methods One hundred and eleven patients with type 2 diabetes mellitus and 25 healthy subjects (normal control group) were enrolled in this study. Urinary VCAM-1, urinary microalbumin and serum creatinine were measured to calculate the glomerular filtration rate (e GFR) . The correlation between urinary VCAM-1 and urinary microalbumin and e GFR was analyzed. The ROC curve was used to evaluate the clinical significance of VCAM-1 in the assessment of kidney injury in type 2 diabetic patients. Results The level of VCAM-1 in diabetic patients was significantly higher than that in normal controls (P <0.01). The level of VCAM-1 was negatively correlated with e GFR (r = -0.809, P <0.01) The urinary albumin and serum creatinine were positively correlated (r = 0.812,0.758, P <0.01). The AUC of VCAM-1 in the diagnosis of diabetic nephropathy was 0.951 with a critical value of 38.26 ng / ml. Conclusion The detection of urine VCAM-1 in patients with diabetes mellitus has certain reference value for the diagnosis of disease and judgment of illness.