【摘要】 目的 探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和肾损伤因子-1(KIM-1)水平在糖尿病肾病(DN)早期诊断中的意义。方法 48例2型糖尿病T2DM患者根据尿白蛋白排泄率(UAER)分为正常白蛋白尿(NA)组，微量蛋白尿(MA)组，和临床肾病(CA)组，同时随机选取同期健康体检者12例名为健康对照(NC)组。检测尿NGAL和KIM-1水平，分析两者与肾小球率过滤(GFR)的相关关系。应用受试者工作特征曲线(ROC)观察两者诊断2型DN患者的敏感性和特异性。结果 各组NGAL水平随UAER水平增加而增加，且组间差异有统计学差异意义(P<<0.05);各组KIM-1水平对比与对照NC组相比均显著提高(P

　　【关键词】糖尿病肾病;中性粒细胞明胶酶相关性脂质运载蛋白;肾损伤因子-1

　　Value of urinary NGAl and KIM-1 in Diagnosing diagnosing Early early phase of Diabetic diabetic Nephropathynephropathy  SUN Jian-min, LV Xiao-feng, YAO Lu, ZHANG Li, GAO Xiao-xiao, WANG Su-linget al. Department of Endorinology, General Hospital of Beijing Military Command, Beijing 100700,China

　　Corresponding author: LV Xiao-feng, E-mail:neifenmike@126.com

     【Abstract】 Objective To explore the clinical changes and diagnostic significance of urine neutrophil gelatinase- associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in patients with diabetic nephropathy (DN). Methods Forty-eight type 2 diabetic patients were divided, according to urinary albumin excretion rate (UAER), into groups normal albuminuria (NA), micro albuminuria (MA), clinical albuminuria (CA), and another 12 healthy subjects were randomly chosen as control group. NGAL and KIM-1 levels were detected by ELISA. The relationship of NGAL and KIM-1 to glomerular filtration rate (GFR) was analyzed and the sensitivities of NGAL and KIM-1 were evaluated by receiver operating characteristic (ROC) curve in diagnosis of DN. Results NGAL levels increased with the increase of UAER in each group, significant differences of which were shown among all the groups (P<0.05); Compared to control group, KIM-1 levels in diabetic groups elevated significantly (P<0.05). Significant difference was demonstrated between CA group and the other two groups (NA and MA) (P<0.05); Pearson correlation analysis showed that NGAL and KIM-1 levels were negatively correlated with GFR (r= ﹣0.844,﹣0.747; P<0.01), and the former was closer with GFR; The areas under ROC curve were 0.875 and 0.790, respectively. Conclusion Urinary NGAL level is to be a sensitive indicator for clinical monitoring, so as for early diagnosis of type 2 DN.

　　【Key words】Diabetic nephropathy; Neutrophil gelatinase- associated lipocalin; Kidney injury molecule-1