| Objective: By measuring the concentrations of plasma CysC,plasma ?2-MG,urine NAG,and urine NGAL in patients with chronic kidney disease(CKD),the correlation between the four patients and the degree of renal tubulointerstitial injury was investigated,and the diagnostic value of their combined detection on renal tubulointerstitial injury in patients with CKD was analyzed.Methods: A total of 170 plasma and urine samples were collected from December 2018 to November 2019 in patients in the Department of Nephrology of the First Affiliated Hospital of Bengbu Medical College who underwent renal pathology biopsy.According to the results of renal pathological biopsy of the patient and the inclusion and exclusion criteria of the research object combined with this experiment,49 cases were excluded.The remaining 121 cases were divided into four groups according to the renal interstitial damage.30 cases of renal puncture showed no renal interstitial lesions as the normal renal interstitial group.The remaining 91 patients with CKD who clearly had renal tubule interstitial damage were classified semi-quantitatively according to Katafuchi's pathological scoring criteria.According to the scoring results,it was divided into 40 cases in the mild injury group(1-3 points),31 cases in the moderate injury group(4-6 points)and 20 cases in the severe injury group(7-9 points).Collect general clinical data and determine the plasma CysC,plasma ?2-MG,urine NAG,urine NGAL concentration levels of each group,and analyze whether there is a difference in CKD renal interstitial damage between age and gender;analyze between the four groups Whether the difference between the concentrations of various indicators is statistically significant;analysis of the diagnostic value of the combined detection of four indicators on CKD renal tubular interstitial injury and mild renal tubular interstitial injury of CKD.Results:(1)the difference analysis of age and sex composition ratio between each group showed that the difference between age and sex composition ratio was not statistically significant(P>0.05).(2)the higher the degree of renal interstitial injury in CKD patients,the higher the concentrations of plasma CysC,plasma ?2-MG,urine NAG and urine NGAL(P<0.01).In the renal tubular interstitial group,mild damage to normal group,the various indicators of moderate damage,severe injury group levels are increased,except in the plasma ?2-MG,chronic kidney disease(CKD)renal tubular interstitial injury group compared with normal renal tubule interstitial group had no significant difference(P > 0.05),the rest of the indicators in each level of concentration difference between statistically significant(P < 0.05).(3)the combined diagnosis of renal tubulointerstitial injury in CKD by plasma CysC,plasma ?2-MG,urine NAG and urine NGAL had the largest area under the ROC curve(0.986),confidence interval(0.972,1),sensitivity(95.6%)and specificity(93.3%).(4)the combined diagnosis of CKD with plasma CysC,plasma ?2-MG,urine NAG,and urine NGAL had the largest area under the ROC curve(0.964),confidence interval(0.927,1),sensitivity(95.0%),and specificity(86.7%).Conclusion: In patients with CKD,plasma CysC,plasma ?2-MG,urine NAG,and urine NGAL are positively correlated with the degree of tubular interstitial injury,which can be used as a biological marker to reflect the degree of tubular interstitial injury in patients with CKD.Plasma CysC,plasma ?2-MG combined with urine NAG and NGAL,have positive clinical significance in detecting the degree of tubulointerstitial injury,especially in improving the sensitivity and specificity of diagnosing the degree of mild tubulointerstitial injury in early CKD. |
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