胱抑素C水平的测定在2型糖尿病肾功能评价中的应用

The application of cystatin C determination in the appraisal of Type 2 diabetes mellitus

目的探讨通过测定2型糖尿病(T2DM)胱抑素C(Cys C)的水平,评价其对T2DM患者肾功能早期损害的价值。方法选择156例T2DM患者,检测其Cys C、血肌酐(Scr)、内生肌酐清除率(Ccr)水平。根据Ccr水平将T2DM分为肾功能正常组、肾功能代偿组、肾功能失代偿组和肾功能衰竭组。健康对照组为健康体检者,均进行CysC、Scr及Ccr检测。将T2DM各组Cys C水平与健康对照组比较;Cys C与Scr对糖尿病肾病(DN)的灵敏度进行比较;Cys C与Scr、Ccr的相关性比较。结果 T2DM肾功能损害各组中,Cys C显著高于健康对照组,差异有统计学意义,P<0.01;T2DM肾功能正常组中,Cys C与健康对照组比较,差异无统计学意义,P>0.05;Cys C对DM诊断的灵敏度明显高于Scr;Cys C与Ccr呈负相关,与Scr呈正相关。结论 Cys C可作为T2DM患者早期肾功能损害判断的理想内源性指标,通过对Cys C的检测,可在早期对T2DM肾功能损害作出准确判断,进行早期治疗,提高疗效。

Objective To probe the value of Cystatin C （Cys C） in the judgement of early damage of type 2 diabetes mellitus （T2DM）. Methods A total of 156 T2DM patients were chosen to check the Cys C,serum ereatinine （Scr） and creatinine clearance （Ccr）. According to the levels of Cer, they were divided into normal kidney function group, compensatory kidney function group, loss-compensatory kidney function group and renal failure group. All people in the control group were healthy and were conducted the checks of Cys C,Scr and Ccr. The level of Cys C in eaeh group of T2DM was compared with that in control group;the sensitivities of Cys C and Scr against the diabetic nephropathy （DN） were compared;the correlations among the Cys C, Scr and Ccr were compared. Results The levels of Cys C in the T2DM kidney function damage groups were obviously higher than that in the control group,in which the differences had statistical significance,P〈0.01. The level of Cys C in T2DM normal kidney function group was compared with that in the control group,in which the differences had no statistical significance, P〉0.05. The sensitivity of Cys C in the diagnosis of DM was obviously higher than that of Ser. The Cys C had negative correlation with Ccr and had positive correlation with Scr. ConcLusion The Cys C can be used as the ideal endogenous index in the determination of early kidney function damage for the T2DM patients. After checking the level of Cys C,the accurate judgement can be made for the early kidney function damage of T2DM patients,then carrying out the early treatment and improving the curative effect.