血清胱抑素检测对糖尿病早期肾功能损害的诊断意义

Diagnostic significance of serum Cystatin C testing in the early stage renal damage in Diabetes

目的：探讨血清半胱氨酸蛋白酶抑制剂C（CysC）水平检测对糖尿病早期肾功能损害的诊断意义。方法：将80例I型或2型糖尿病患者按尿白蛋白排泄率（UAER）分为3组，无糖尿病的正常人为1组。A组为20例无糖尿病的正常人。B组为正常蛋白尿患者32例（UAER〈20μg／min）；C组为微量蛋白尿患者29例（UAER20-200μg／min）；D组为大量蛋白尿患者19例（UAER〉200g／min）；同时测定各组血肌酐及Cystatin C，并计算肌酐清除率。结果：血清Cystatin C和CCr在B、C、D三组间的差异有显著性（P〈0.05），而Scr在B组和C组间的差异无显著（P〉0.05），而C组的Scr高于A、B、D组，差异有显著性（P〈0.05）。Cystatin C在A组和B组间比较无显著性差异（P〉0.05）；C组、D组与A组、B组比较有显著性差异（P〈0.001）。结论：Cystatin C是临床上诊断早期糖尿病肾病的敏感指标之一。

Objective： To explore the diagnostic significance of serum cystatin C （Cys C） testing in the early Stage renal damage in Diabetes. Methods： According to urinary albumin excretion rate （UAER） ,80 cases of type 1 or type 2 diabetic patients were divided into 3 groups,non-diabetic normal for one group. A group was 20 healthy persons without diabetes.B group was 32 cases of patients with normal albuminuria（UAER〈20μg/min） ;C group was 29 cases of patients with microalbuminuria （UAER20-200μg/min）;D Group were 19 cases of patients with substantial proteinuria （UAER〉200g/min） ;simultaneously measured serum creatinine and Cystatin C of each group, and calculated creatinine clearance rate. Results： there was a significant difference of serum Cystatin C and CCr among the B, C, D three groups （P〈0.05） ,and Scr has no significant differences between the B group and C group （P〉0.05） ,while Scr of the C group was higher than the A,B,D group,there was a significant difference （P〈 0.05）.The comparison of Cystatin C in the A group and B group has no significant difference （P〉0.05） ;and the comparison among C group, D group and A group, B group has significant difference （P〈0.001）. Conclusion： Cystatin C is one of the sensitive indicators to diagnosis early stage clinical diabetic nephropathy.