应用血清西司他汀浓度测定评价早期糖尿病肾病肾小球功能

Evaluate of glomerulus function of early diabetic nephropathy by serum cystatin concentration assaying

目的 测定 2型糖尿病早期肾病患者血清西司他汀浓度 (CystatinC ,CysC) ,观察其变化情况 ,以评价糖尿病早期肾病肾小球功能。方法 住院的 14 1例 2型糖尿病患者 ,根据 2 4小时尿微量白蛋白排泄率 (Urinealbuminexcretionrate ,UAER)分为三组 :A组 ,UAER <30mg 2 4h ;B组 ,UAER 30～ 30 0mg 2 4h ;C组 ,UAER≥ 30 0mg 2 4h。采用散率散射比浊法对所有患者测定CysC ,并与内生肌酐清除率 (creatinineclearancerate ,Ccr)比较。结果 与正常对照组比较 ,B、C两组UAER、CysC均高于正常对照组 ,Ccr低于正常对照组 (P <0 . 0 1) ,A组与正常对照相似 (P >0 . 0 5 ) ;3组之间比较 ,CysC、UAER值C组明显高于B、A组 ,B组高于A组 ;Ccr值C组低于B、A组 ,B组低于A组 (P <0 . 0 1)。相关分析显示 ,CysC与UAER呈显著正相关 ,与Ccr呈显著负相关 (P <0 . 0 1)。结论 CysC能较准确反映肾小球滤过功能 ,而且测定只需一份血标本 ,不需收集尿标本 ,方法简便、快捷。

Objective To evaluate glomerulus function of early diabetic nephropathy by assaying Cystatin concentration (Cys C) and observing the change of concentration.Methods 141 diabetes mellitus patients were divided into 3 groups according to urine albumin excretion rate (UAER): Group A, UAER <30 mg/24h; Group B,UAER 30～300 mg/24h; Group C,UAER ≥300 mg/24h.. Using scattering turbidimetry to assay CysC and comparing with creatinine clearance rate (Ccr).Results Comparing with contrast group, UAER and CysC of group B and C were higher than contrast group, Ccr was lower than contrast group (P<0.01), Group A was similar with contrast group (P>0.05); CysC and UAER of Group C were higher than group B and A obviously, Group B was higher than group A; Ccr of group C was lower than group B and A,group B was lower than group A (P<0.01).Correlation analysis displayed, CysC was positive correlation with UAER and negative correlation with Ccr (P<0.01).Conclusion CysC can reflect the function of glomerular filtration accurately, it need only one blood sample and needn't urine sample,this method is quick and convenient.