胱抑素、视黄醇结合蛋白和脑钠肽对2型糖尿病早期肾病的诊断价值

Significance of serum cystatin C,retinol-binding protein and brain natriuertic peptide in the diagnosis of early stage diabetic nephropathy in patients with type 2 diabetes

目的探讨血清胱抑素(CysC)、视黄醇结合蛋白(RBP)及脑钠肽(BNP)联合检测对2型糖尿病(T2DM)早期肾病的临床诊断价值。方法 112例T2DM患者按尿蛋白定量分为两组,每组56例。DM1组24-h尿蛋白量<150mg,DM2组24-h尿蛋白量150～300mg;另选非糖尿病56例作为对照(C组)。测定三组血清CysC、RBP及BNP。结果 DM1组、DM2组血清CysC、RBP和BNP均明显高于C组(P<0.01);DM2组血清CysC、RBP和BNP明显高于DMl组(P<0.01)。在DMl组和DM2组,三项指标联合检测优于单项检测。结论 CysC、RBP及BNP均是T2DM早期肾病的敏感指标,三项联合检测有助于早期诊断糖尿病肾病。

Objective To evaluate the clinical significance of serum cystatin C（CysC）,retinol-binding protein（RBP） and brain natriuertic peptide（BNP） in the diagnosis of early stage diabetic nephropathy in patients with type 2 diabetes（T2DM）.Methods One hundred and twelve T2DM patients were divided into two groups with 56 cases each.The patients in group DM1 had 24-h urine protein 150 mg and those in group DM2 had 24-h urine protein 150-300 mg.Another 56 healthy people were taken as normal control（group C）.Serum levels of CysC,RBP and BNP were measured.Results Serum levels of CysC,RBP and BNP were higher in groups of DM1 and DM2 than those in group C,which were higher in group DM2 than those in group DM1（P〈0.01）.Combined examination of serum levels of CysC,RBP and BNP had higher diagnostic efficacy than single one in groups of DM1 and DM2.Conclusion Serum levels of CysC,RBP and BNP are the sensitive criteria and combined examination of serum levels of CysC,RBP and BNP is helpful in early diagnosis of diabetic nephropathy in T2DM patients.