3项指标联合检测对早期糖尿病肾损伤的诊断价值

Value of associated detection of serum CysC,Hcy and hs-CRP in diagnosis of early diabetic nephropathy

目的探讨胱抑素C(CysC)与同型半胱氨酸(Hcy)及超敏C反应蛋白(hs-CRP)联合检测对早期糖尿病肾损伤的诊断价值。方法 86例2型糖尿病(T2DM)患者分为40例不伴DN组和46例伴DN组,对照组为体检健康者40例。采用全自动生化分析仪测定CysC、Hcy、hs-CRP及尿微量清蛋白(mALB)含量。结果 T2DM组CysC、Hcy、hs-CRP和尿mALB含量明显高于健康对照组,差异有统计学意义(P<0.01),且联合检测阳性率达91.9%,明显高于单项检测。结论 DN患者血清CysC、Hcy和hs-CRP水平随着尿mALB的增加而升高,提示可能与DN的进展有关,是糖尿病肾病新的危险因素,可作为预测糖尿病肾损伤及其损伤程度的指标。CysC、Hcy及hs-CRP是糖尿病早期肾损伤的敏感指标,联合检测更为敏感。

Objective To explore the value of associated detection of serum cystatin C（CysC）,homocysteine （Hcy） and high sensitive C-reactive protein（hs CRP）in diagnosis of early diabetic nephropathy. Methods 86 patients with type 2 diabetes mellitus（T2DM） were divided into DM group （40 cases） without diabetic nephropathy and DN group （46 cases） with diabetic nephropathy and other healthy physical subjects （40 cases） were as control group. Serum CysC, Hcy and hs-CRP were examined by automatic biochemical analyzer,and urinary albumin（mALB） was detected for comparison. Results In type 2 diabetes group,CysC, Hcy, hs-CRP and mALB were significantly higher than those in the normal control group（ P〈0. 01） and the positive rate of combined detection for CysC, Hey and hsCRP was 91.9%,significantly higher than that of single test. Conclusion The levels of CysC, Hcy and hs-CRP are increased with mALB increase in the DN patients,indicating which may be related to the progress of DN and could be increased with the kidney damage being increased gradually in diabetic nephropathy, being as the new risk factors. They might be a predictor of early diabetic renal injury and renal damage. CysC, Hey and hs-CRP are the sensitive in- dicators of early kidney damage,and their joint detection will be more sensitive.