[摘要] 目的 探究尿N-乙酰-β-D-氨基葡萄糖苷酶与尿肌酐比值（NAG/Crea）、转铁蛋白（TRF）检测在糖尿病肾病（DN）早期诊断中的应用价值。方法 选取我院2017年3月～2020年6月早期DN患者102例作为DN组，另选择同期单纯糖尿病（DM）患者102例作为单纯DM组。比较2组临床资料、尿NAG/Crea、TRF水平，评价尿NAG/Crea、TRF与临床指标相关性，分析DN发生的影响因素，采用受试者工作特征（ROC）曲线评价尿NAG/Crea、TRF对早期DN的诊断价值。结果 2组DM病程、合并高血压、尿β2微球蛋白（β2-MG）、尿mAlb、血清Cys-C差异有统计学意义（P＜0.05）；DN组尿NAG/Crea、TRF高于单纯DM组（P＜0.05）；Pearson相关性分析，尿NAG/Crea（r=0.743、0.748、0.557）、TRF（r=0.524、0.633、0.409）与尿β2-MG、尿mAlb、血清Cys-C呈正相关（P＜0.05）；Logistic回归分析，DM病程、合并高血压、尿β2-MG、尿mAlb、血清Cys-C、尿NAG/Crea、TRF是DN发生的重要影响因素（P＜0.05）；ROC曲线分析，将尿NAG/Crea、TRF进行Logistic二元回归拟合，返回预测概率Logit(P)作为独立检验变量，获取联合诊断AUC为0.878，95%CI为0.830～0.926，P＜0.001，敏感度为76.47%，特异度为88.24%，优于两者单独诊断（P＜0.05）。结论 尿NAG/Crea、TRF是诊断早期DN的敏感因子，联合检测具有可靠诊断效能。

[Abstract] Objective To explore the value of detecting urine N-acetyl-β-d-glucosaminidase/Creatinine (NAG/Crea) and transferrin (TRF) in the early diagnosis of diabetic nephropathy (DN). Methods 102 patients with early DN from March 2017 to June 2020 in our hospital were selected as the DN group, and 102 patients with simple diabetes mellitus (DM) during the same period were selected as the simple DM group. The clinical data, urine NAG/Crea, TRF levels of the two groups were compared, the correlation between urine NAG/Crea, TRF and clinical indicators was evaluated, and the influencing factors of DN were analyzed. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of urine NAG/Crea and TRF in early DN. Results There were statistically significant differences in the course of DM, complicated hypertension, urinary β2-microglobulin (β2-mg), urine mAlb, and serum Cys-C between the two groups (P＜0.05). The urine NAG/Crea and TRF in the DN group were higher than those in the DM group (P＜0.05). Pearson correlation analysis showed that urine NAG/Crea (r=.0.743, 0.748, 0.557), TRF (r=0.524, 0.633, 0.409) were positively correlated with β2-mg, urine mAlb, and serum Cys-C (P＜0.05). Logistic regression analysis showed that the course of DM, complicated hypertension, β2-mg, urine mAlb, serum Cys-C, urine NAG/Crea, TRF were important factors influencing the occurrence of DN (P＜0.05). ROC curve analysis. Logistic binary regression fitting was performed for urine NAG/Crea and TRF, and the predictive probability Logit(P) was returned as an independent test variable. The AUC of the combined diagnosis was 0.878, the 95% CI was 0.830～0.926, P＜0.001, the sensitivity was 76.47%, the specificity was 88.24%, which was better than the two diagnosis alone (P＜0.05). Conclusion Urine NAG/Crea and TRF are sensitive factors for the diagnosis of early DN, and combined detection has reliable diagnostic efficacy.