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目的:评估尿液血管内皮生长因子(uVEGF)能否作为诊断早期糖尿病肾病(DN)生物学标志物。方法:选择2015年4月至10月于郑州大学第一附属医院就诊的2型糖尿病患者94例,分为正常白蛋白尿组(n=30),微量白蛋白尿组(n=33),大量白蛋白尿组(n=31),另选30例健康者作为对照组,用酶联免疫吸附法(ELISA)检测各组uVEGF水平。各组患者病程、血清肌酐、尿酸、空腹血糖、糖化血红蛋白等用Logistic回归分析DN相关临床指标,ROC曲线评估灵敏度及特异性。结果:与健康对照组uVEGF(18.44±0.73 pg/ml)相比,大量白蛋白尿组uVEGF(90.07±7.02 pg/ml,P<0.001),微量白蛋白尿组uVEGF(75.88±9.60 pg/ml,P<0.001)和正常白蛋白尿组uVEGF(33.11±5.20 pg/ml,P=0.02)均显著升高。uVEGF与尿白蛋白(r=0.748,P<0.001)、病程(r=0.714,P<0.001)、血清尿素氮(r=0.466,P=0.004)、估算的肾小球滤过率(r=0.437,P=0.005)、血清肌酐(r=0.412,P=0.013)和总胆固醇(r=0.377,P=0.023)成显著正相关。ROC曲线示:uVEGF早期诊断DN的cut-off值为42.573 pg/ml,敏感度为94.7%,特异度为96.4%。结论:uVEGF可作为早期DN诊断的生物学标志物。
PURPOSE: To evaluate whether urine VEGF can be used as a biomarker for the diagnosis of early diabetic nephropathy (DN). Methods: Ninety-four patients with type 2 diabetes who were treated at the First Affiliated Hospital of Zhengzhou University from April to October 2015 were divided into two groups: normotensive albuminuria group (n = 30), microalbuminuria group (n = 33) A large number of albuminuria group (n = 31), another 30 healthy subjects were selected as control group, and the levels of uVEGF in each group were detected by enzyme-linked immunosorbent assay (ELISA). The course of disease, serum creatinine, uric acid, fasting blood glucose and glycosylated hemoglobin in all groups were analyzed by logistic regression. The ROC curve was used to evaluate the sensitivity and specificity. Results: Compared with uVEGF (18.44 ± 0.73 pg / ml) in healthy control group, uVEGF (90.07 ± 7.02 pg / ml, P <0.001) in patients with albuminuria and patients with microalbuminuria (75.88 ± 9.60 pg / , P <0.001) and normal albuminuria (33.11 ± 5.20 pg / ml, P = 0.02). Serum urea nitrogen (r = 0.466, P = 0.004), estimated glomerular filtration rate (r = 0.748, P <0.001) 0.437, P = 0.005), serum creatinine (r = 0.412, P = 0.013) and total cholesterol (r = 0.377, P = 0.023) The ROC curve showed that the cut-off value of early diagnosis of uVEGF was 42.573 pg / ml, the sensitivity was 94.7% and the specificity was 96.4%. Conclusion: uVEGF can be used as a biomarker for diagnosis of early DN.