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目的分析尿微量白蛋白在2型糖尿病(T2DM)合并冠心病的老年患者早期肾损伤的检测价值。方法选取2型糖尿病合并冠心病且有肾损伤的患者80例作为观察组,2型糖尿病合并冠心病但无肾损伤的患者80例作为对照组,分别检测两组患者的空腹血糖(FPG)、2 h血糖(2 h PG)、总胆固醇(TC)、甘油三酯(TG)、尿微量白蛋白和24 h尿微量白蛋白排泄率及血清胱抑素C等,并探讨在不同尿微量白蛋白截断点时对2型糖尿病合并冠心病患者早期肾损伤的诊断价值。结果两组FPG、2 h PG、TC和TG比较差异均无统计学意义(P>0.05)。观察组Cys C、尿微量白蛋白值和24 h尿微量白蛋白排泄率均高于对照组,差异有统计学意义(P<0.05)。在以尿微量白蛋白≥18.2 mg/L为截断点时的临床诊断价值最高,灵敏度为95.0%,特异度为88.8%,约登指数为83.8%,阳性预测值为89.4%,阴性预测值为94.7%,ROC曲线下面积最大0.919。结论尿微量白蛋白对2型糖尿病合并冠心病患者早期肾损伤的检测价值较高。
Objective To analyze the value of urine microalbumin in early renal injury in elderly patients with type 2 diabetes mellitus (T2DM) complicated with coronary heart disease. Methods Eighty patients with type 2 diabetes mellitus complicated with coronary heart disease and kidney injury were selected as observation group and 80 patients with type 2 diabetes mellitus complicated with coronary heart disease but without renal injury as control group. Fasting plasma glucose (FPG) 2 h blood glucose (2 h PG), total cholesterol (TC), triglyceride (TG), urinary albumin and 24 h urinary albumin excretion rate and serum cystatin C, Diagnostic Value of Protein Truncation Point for Early Renal Injury in Patients with Type 2 Diabetes Mellitus and Coronary Heart Disease. Results There were no significant differences in FPG, 2 h PG, TC and TG between the two groups (P> 0.05). The Cys C, urine microalbuminuria and 24 h urinary albumin excretion rate in the observation group were higher than those in the control group, with significant difference (P <0.05). The urinary albumin ≥ 18.2 mg / L as the cut-off point of the highest clinical diagnostic value, the sensitivity was 95.0%, the specificity was 88.8%, the Youden index was 83.8%, the positive predictive value was 89.4%, the negative predictive value was 94.7%, the area under ROC curve is 0.919. Conclusion Urine microalbuminuria has a higher value of detection of early renal injury in type 2 diabetic patients with coronary heart disease.