妊娠期糖代谢异常患者血清胱抑素C测定的意义

The significance of serum Cystatin C examination in abnormal glucose metabolism patients during the pregnancy

目的探讨血清胱抑素C(Cystatin,Cys C)对妊娠期糖尿病肾损伤早期诊断的意义。方法收集2009年6月至2010年7月在天津市中心妇产科医院产科就诊的246例妊娠期糖代谢异常患者,其中妊娠期糖尿病(gestational diabetes mellitus,GDM)152例,妊娠期糖耐量减低(gestational impaired glucosetolerance,GIGT)94例,同期健康孕妇151例,测定血尿素(blood urea,BUN)、肌酐(serum creatinine,Scr)、肌酐清除率(creatinite clearance rate,Ccr)和胱抑素C(Cystatin,Cys C)等生化指标。结果 GDM组与正常组和GIGT组比较,Cys C、BUN、Scr水平明显升高,而Ccr显著降低,差异有统计学意义(P<0.05)。GIGT组与正常组相比,BUN、Scr数值升高,但差异无统计学意义(P>0.05);Cys C数值升高,差异有统计学意义(P<0.05);Ccr水平降低,差异有统计学意义(P<0.05)。结论 Cys C的测定较BUN、Ccr更敏感,可以为早期的肾脏损害提供客观的评估标准,对诊断妊娠期糖尿病肾病有着重要的参考价值和临床意义。

Objective To study the value of serum Cystatin C （ Cys C） on the diagnosis of early renal injury in gestational diabetes patients. Methods From June 2009 to July 2010, 246 cases with abnormal glucose metabolism during the pregnancy were chosen including 152 cases with gestational diabetes mellitus （ GDM ） and 94 cases with gestational impaired glucose tolerance（GIGT）. In the same period, Blood urea（BUN） , serum creatinine（Scr） , creatinine clearance rate（Ccr） , Cystatin C（ Cys C） and other biochemical indicators of 151 health pregnant women （as the normal group） were detected. Results The level of Cys C, BUN, Scr in GDM group increased significantly, while CCr level decreased significantly that the difference was statistical significance （ P 〈 0.05 ） between the GDM group and GIGT group or normal group. The level of BUN, Scr increased in GIGT group but the difference was no statistical significance（P 〉 0. 05） between GIGT group and normal group. Cys C level increased and Ccr level was decreased statistically in GIGT group that the difference was statistical significance （ P 〈 0.05 ） between GIGT group and normal group. Conclusion For serum Cys C is more sensitively than the level of BUN and Cr, the evaluation of serum CysC may provide an objective and reliable evaluation criterion in early renal injury that has the important reference value and clinical value on the diagnosis of early renal trauma in gestational diabetes patients.