糖尿病肾病患者血清半胱氨酸蛋白酶抑制剂C、脂蛋白(α)和超敏C反应蛋白的检测及其临床意义

Clinical significance of determination of serum cystatin C,lipoprotein (α) and high sensitivity C-reactive protein in type 2 diabetic patients with early renal impairment.

目的检测2型糖尿病患者血清中半胱氨酸蛋白酶抑制剂C(CysC)、脂蛋白(α)[LP(α)]和超敏C反应蛋白(hs-CRP)水平,并探讨其临床意义。方法 126例2型糖尿病患者分为单纯糖尿病组(DM组)40例、早期糖尿病肾病组(EDN组)44例、临床糖尿病肾病组(DN组)42例,以70例健康体检者作为对照组,采用BECKMAN UniCel Dxc600全自动生化分析仪分别检测血清中的CysC、LP(α)以及hs-CRP水平。结果 2型糖尿病患者中CysC、LP(a)、hs-CRP水平均高于正常对照组(P<0.01),临床糖尿病肾病组患者的CysC、LP(a)、hs-CRP水平也明显高于单纯糖尿病组和早期糖尿病肾病组(P<0.01),在2型糖尿病患者中,血清中的CysC、LP(α)、hs-CRP与尿微量白蛋白(mALB)呈正相关,联合检测CysC、LP(α)、hs-CRP对糖尿病肾病的阳性率达88.5%。结论 CysC、LP(α)、hs-CRP作为诊断糖尿病早期肾损害的敏感指标,联合检测更具实用价值。

Objective To study the clinical significance of measurement of serum cystatin C （Cysc）, lipopmtein α （LPα） and high sensitivity C -reactive protein （hs - CRP） in type 2 diabetic mellitus （T2DM）patients with early renal impairment. Methods One hundred and twenty six patients were divided into three groups： 40 cases in simple diabetic group （DM）, 44 cases in early diabetic nephmpathy group （EDN） and 42 cases in clinical diabetic nephropathy group （ DN）, and 70 healthy persons were chosen as normal control group. Serum levels of Cysc, LP （α） and hs - CRP were detected by BECKMAN UniCel Dxc600 automatic biochemistry analyzer. Results Serum levels of Cysc, LP （α） and hs - CRP in T2DM patients were higher than those of normal control group （ P 〈0.01 ）, they were also significantly higher in DN group than in DM group and EDN group （ P 〈 0.01 ）. The serum levels of Cysc, LP （α） and hs - CRP were positively correlated with urinary mALB in T2DM patients. Conclusion Serum levels of Cysc, LP （α） and hs - CRP are sensitive indicators for detection of early renal impairment in patients with type 2 diabetes mellitus.