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目的血清视黄醇结合蛋白(RBP)及中性粒细胞明胶酶相关载脂蛋白(NGAL)在糖尿病肾病(DN)诊治中的临床应用价值研究。方法 148例2型糖尿病患者,依据尿白蛋白肌酐比值(ACR)结果分成正常蛋白尿组、早期糖尿病肾病组和临床肾病组,同期50例健康体检者为对照组。常规进行RBP、NGAL、胱抑素(Cys-C)、血肌酐、尿素氮和β2-微球蛋白检测。结果早期糖尿病肾病组及临床肾病组BUN、Cr、Cys-C、β2-MG、RBP、NGAL水平及阳性率显著高于正常蛋白尿及对照组,差异有统计学意义(P<0.05)。RBP、NGAL的阳性率显著高于其他指标,差异有统计学意义(P<0.05)。用于DN的早期诊断,RBP特异度显著优于NGAL及ACR,差异有统计学意义(P<0.05)。DN患者RBP水平与NGAL、ACR呈显著正相关(P<0.01)。结论早期糖尿病肾病及临床肾病患者血清RBP及NGAL明显升高,可能与疾病的发生发展密切相关。
Objective To investigate the clinical value of serum retinol binding protein (RBP) and neutrophil gelatinase - associated apolipoprotein (NGAL) in the diagnosis and treatment of diabetic nephropathy (DN). Methods 148 patients with type 2 diabetes mellitus were divided into normal proteinuria group, early diabetic nephropathy group and clinical nephropathy group according to urinary albumin creatinine ratio (ACR). Fifty healthy subjects at the same period were taken as control group. RBP, NGAL, cystatin (Cys-C), serum creatinine, urea nitrogen and β2-microglobulin were routinely tested. Results The levels of BUN, Cr, Cys-C, β2-MG, RBP, NGAL and the positive rate in early diabetic nephropathy group and clinical nephropathy group were significantly higher than those in normal proteinuria group and control group (P <0.05). RBP, NGAL positive rate was significantly higher than other indicators, the difference was statistically significant (P <0.05). For the early diagnosis of DN, RBP specificity was significantly better than NGAL and ACR, the difference was statistically significant (P <0.05). The level of RBP in DN patients was positively correlated with NGAL and ACR (P <0.01). Conclusions Serum RBP and NGAL were significantly increased in patients with early diabetic nephropathy and clinical nephropathy, which may be closely related to the occurrence and development of the disease.