| 血清ANCA、ACLA联合β2-MG对早期糖尿病肾病诊断的临床价值 |
| 投稿时间：2017-07-14 修订日期：2017-09-15 点此下载全文 |
| 引用本文：王尔萍,韩林.血清ANCA、ACLA联合β2-MG对早期糖尿病肾病诊断的临床价值[J].医学研究杂志,2018,47(5):52-54,59 |
| DOI：
10.11969/j.issn.1673-548X.2018.05.013 |
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| 基金项目:云南省自然科学基金资助项目（面上项目）（2015FZ123） |
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| 中文摘要:目的 探究血清抗中性粒细胞胞质抗体（ANCA）、抗心磷脂抗体（ACLA）联合β2微球蛋白（β2-MG）对早期糖尿病肾病（DN）诊断的临床价值。方法 选取2016年2月~2017年2月收治的50例早期糖尿病肾病患者并征集50名正常志愿者，分别作为观察组和对照组。观察并记录下各组ANCA、ACLA及β2-MG表达阳性率，探究并分析ANCA、ACLA、β2-MG与DN的相关性，并评价ANCA、ACLA、β2-MG及ANCA、ACLA联合β2-MG等诊断方法诊断效率。结果 观察组患者ACLA、ANCA、β2-MG抗体表达阳性率明显高于对照组（P<0.05）；不同ACLA、ANCA、β2-MG水平下DN发生率比较差异有统计学意义（P<0.05），ACLA、ANCA、β2-MG与早期糖尿病肾病具有一定的相关性（P<0.05）。ACLA+ANCA+β2-MG联合诊断敏感度明显高于单纯ACLA、ANCA、β2-MG （P<0.05），特异性低于单纯RBP、Hcy、超声评分诊断，ACLA+ANCA+β2-MG联合诊断一致性高于单纯ACLA、ANCA、β2-MG （P<0.05）。由ROC曲线结果可知，ACLA+ANCA+β2-MG联合诊断对于早期DN的诊断效率明显优于单纯ACLA、ANCA、β2-MG诊断。结论 ACLA+ANCA+β2-MG联合诊断较单纯ACLA、ANCA、β2-MG诊断更能有效提高早期糖尿病肾病诊断准确率，值得临床推广。 |
| 中文关键词:抗中性粒细胞质抗体 抗心磷脂抗体 早期糖尿病肾病 β2微球蛋白 |
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| Clinical Value of Serum ANCA, ACLA and β2-MG in Diagnosis of Early Diabetic Nephropathy |
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| Abstract:Objective To explore the clinical value of serum ANCA (antineutrophil cytoplasmic antibody), and ACLA (anticardiolipin antibodies) combined with β2-MG (β2 microglobulin) in the diagnostis of DN (early diabetic nephropathy).Methods Fifty cases of patients with early diabetic nephropathy treated in our hospital from February 2016 to February 2017 were selected, and 50 normal volunteers were collected, as the observation group and control group. Positive rates of ANCA, ACLA and β2-MG expression of the patients were observed and recorded. The correlation of ANCA, ACLA, β2-MG and DN was explored and analyzed, and ANCA, ACLA, β2-MG and ANCA, ACLA combined with β2-MG diagnostic efficiency were evaluated.Results The positive rates of ACLA, ANCA, and β2-MG antibodies in the observation group were significantly higher than those in the control group (P<0.05). There was difference in DN incidence in different levels of ANCA, ACLA, β2-MG (P<0.05). There was a significant correlation in ACLA, ANCA, β2-MG and myocardial infarction. Combined diagnostic sensitivity ACLA+ANCA+ β2-MG was significantly higher than that of pure ACLA, ANCA, β2-MG (P<0.05). The specificity was lower than that of simple RBP, Hcy and ultrasonic scoring diagnosis. The consistency was higher than that of pure ACLA, ANCA, and β2-MG (P<0.05). According to the results of ROC curve, the diagnostic efficiency of ACLA+ANCA+ β2-MG combined with early diagnosis of DN was significantly better than that of pure ACLA, ANCA and β2-MG.Conclusion Combined use of ACLA+ANCA+ and β2-MG can improve diagnostic accuracy of early diabetic nephropathy,which is more effectively than pure ACLA, ANCA, and β2-MG for diagnosis, and it is worthy of clinical promotion. |
| keywords:ANCA ACLA DN β2-MG |
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