Abstract: Background　Diabetic kidney disease （DKD），a common diabetic complication，has become a major cause of end-stage renal disease. There are no comparative studies about the values of six inflammatory laboratory markers，heparin binding protein （HBP），C-reactive protein （CRP），serum amyloid A protein（SAA），procalcitonin （PCT），white blood cell count （WBC） and neutrophil percentage （N%），in early diagnosing DKD. Objective　To assess the values of six inflammatory markers（HBP，CRP，SAA，PCT，WBC and N%） in early diagnosis of DKD via comparing the levels of them between type 2 diabetic patients and early DKD patients. Methods　Participants were selected from Xianghu Branch，the First Affiliated Hospital of Nanchang University from May to December 2020，including 32 with simple type 2 diabetes，35 with early DKD patients and 30 physical examinees with normal examination results and without organic diseases. Fasting venous blood samples were collected for measuring HBP，CRP，SAA and PCT using quantitative immunofluorescence method，measuring WBC and N% using the automated hematology analyzer. ROC analysis was implemented to evaluate the value of HBP，CRP，and SAA in the early diagnosis of DKD. Results　There were no significant differences in mean levels of PCT，WBC，and N% among three groups（P>0.05）. The mean level of HBP was increased in simple diabetic patients compared with that of healthy controls. The mean levels of HBP，CRP，and SAA in early DKD patients were significantly higher than those of other two groups（P<0.05）. In predicting early DKD，the AUC of HBP was 0.908〔95%CI（0.841，0.975）〕 with 71.4% sensitivity，96.7% specificity and Youden index of 0.681；the AUC of CRP was 0.760〔95%CI（0.644，0.875）〕 with 48.6% sensitivity，96.7% specificity and Youden index of 0.452；the AUC of SAA was 0.836〔95%CI（0.738，0.934）〕 with 74.3% sensitivity，86.7% specificity and Youden index of 0.610. Conclusion　HBP has proved to be more effective in diagnosing DKD，which could be promoted clinically as a predictor of DKD.

Key words: Diabetic kidney disease, Heparin binding protein, C-reactive protein, Serum amyloid A protein, Early diagnosis

摘要： 背景　糖尿病肾病是糖尿病常见并发症之一，已成为终末期肾病的主要病因。肝素结合蛋白（HBP）、C反应蛋白（CRP）、血清淀粉样蛋白A（SAA）、降钙素原（PCT）、白细胞计数（WBC）及中性粒细胞百分数均是临床常见的炎性指标，但上述指标对糖尿病肾病早期诊断价值的比较研究较少。目的　检测单纯2型糖尿病及糖尿病肾病早期患者HBP、CRP、SAA、PCT、WBC及中性粒细胞百分数，比较上述炎性指标对糖尿病肾病早期的诊断价值。方法　选取2020年5—12月在南昌大学第一附属医院象湖院区就诊的单纯2型糖尿病患者32例（DM组）及糖尿病肾病早期患者35例（DKD早期组），选取同期在本院体检健康、无器质性疾病者30例为对照组（Con组）。采集上述三组受试者空腹静脉血，其中HBP、CRP、SAA、PCT采用免疫荧光干式定量法进行检测，WBC及中性粒细胞百分数采用全自动模块式血液体液分析仪进行检测。绘制受试者工作特征（ROC）曲线评估HBP、CRP、SAA对糖尿病肾病早期的诊断价值。结果　三组PCT、WBC、中性粒细胞百分数比较，差异均无统计学意义（P>0.05）。DM组HBP高于Con组，DKD早期组HBP、CRP、SAA均高于Con组和DM组（P<0.05）。HBP、CRP、SAA诊断糖尿病肾病早期的ROC曲线下面积分别为0.908〔95%CI（0.841，0.975）〕、0.760〔95%CI（0.644，0.875）〕、0.836〔95%CI（0.738，0.934）〕，灵敏度分别为71.4%、48.6%、74.3%，特异度分别为96.7%、96.7%、86.7%，约登指数分别为0.681、0.452、0.610。结论　HBP对糖尿病肾病具有较高诊断价值，适合作为糖尿病肾病早期的预测指标并在临床推广使用。

关键词: 糖尿病肾病, 肝素结合蛋白, C反应蛋白质, 血清淀粉样蛋白A, 早期诊断