ABSTRACT
Objective To investigate the changes of urinary microalbumin(mALB)and type B urinary na-triuretic peptide(BNP)in the patients with diabetic nephropathy(DN)complicating heart failure and their in-fluence on recent prognosis.Methods A total of 73 patients with diabetes mellitus(DN)complicating heart failure from January 2014 to December 2016 were selected as the observation group and 73 persons undergoing healthy physical examination were selected as the control group.The urinary mALB and BNP levels in the two groups and the patients with different heart function grades were analyzed.The receiver operating characteris-tic(ROC)curve and survival curve were drawn for analyzing their diagnostic value and influence on progno-sis.Results The levels of urinary mALB and BNP levels in the observation group were significantly higher than those in the control group,the difference was statistically significant(P< 0.05).In the observation group,the poorer the heart function,the more obvious the urinary mALB and BNP abnormality,the difference was statistically significant(P<0.05).When the critical value of urinary mALB for diagnosing DN complica-ting heart failure was 18.56 ng/L,the area under the curve(AUC),95% CI,sensitivity and specificity were 0.983,0.964 -0.999,0.986 and 0.900 respectively,the difference was statistically significant(P< 0.05);
ABSTRACT
Objective To investigate the significance of plasma retinol binding protein (RBP),Cystatin C (CysC),soluble intercellular adhesion factor 1 (sICAM 1) and urinary microalbumin (u-MALB) in the detec-tion of early diabetic nephropathy.Methods 40 patients with diabetic nephropathy received from May 2015 to May 2016 at the Capital Medical University Desheng Teaching and Research Center were selected as the ob-servation group and 40 healthy subjects were selected as the control group.Both groups were tested by using immunoassay and biochemical analyzer.Then RBP,CysC,sICAM-1 and u-MALB results in two groups were compared.The sensitivity and specificity of individual and combined detection of related indexes were analyzed by ROC curve.Results The levels of RBP,CysC,sICAM-1 and u-MALB in the observation group [(1.36 ± 0.03)mg/mL,(1.43 ± 0.10)mg/L,(208.72 ± 30.34)ng/mL,(42.39 ± 3.32)mg/L] were higher than those in the control group [(0.33 ± 0.01)mg/mL,(0.14 ± 0.01)mg/L,(85.39 ± 16.85)ng/mL,(10.31 ± 2.20)mg/L],and the difference was statistically significant (P< 0.05).The positive rate of combined detection was higher than single detection of RBP,CysC,sICAM-1 and u-MALB.Conclusion RBP,CysC,sICAM-1 and u-MALB are effective indicators to reflect the patient′s renal injury.The combined detection could effectively improve the positive rate of diagnosis of diabetic nephropathy and monitoring the levels of RBP,CysC,sICAM-1 and u-M ALB level in diabetic nephropathy patients is important for the diagnosis of the onset and the devel-opment of early kidney injury,and the treatment and the progression of the disease.