糖尿病肾病患者血清CysC浓度与SCr、Ccr、β_2-MG比较临床观察

The clinical observation of serum Cystatin C in early diagnosis of diabetic nephropathy

目的通过检测血清胱抑素C(Cys-C),与血清肌酐(SCr)、内生肌酐清除值(Ccr)、β2微球蛋白(β2-MG)结果进行比较,评价其对糖尿病肾病患者早期诊断的价值。方法应用颗粒增强免疫比浊法测定50例健康体检者和100例糖尿病患者的血清胱抑素C、血清肌酐、β2微球蛋白浓度,并同时测量100例患者尿肌酐(UCr)、尿微量白蛋白(MALB)并计算出内生肌酐清除值以及24h尿微量白蛋白。结果早期糖尿病肾病组Cys-C(1.61±0.82)、β2-MG(2.49±1.00)和临床糖尿病肾病组的Cys-C(2.27±1.16)、β2-MG(3.18±1.40)均较单纯糖尿病组Cys-C(0.90±0.19)、β2MG(1.58±0.39)、和正常对照组的检测结果明显增高,有显著差异(P<0.01);单纯糖尿病组Cys-C、β2-MG、SCr和Ccr检测结果和正常对照组比较无显著差异。检验数据分析得知,在早期糖尿病肾病组中,Cys-C、β2-MG和Ccr、SCr阳性率分别为71.8%、93.7%、31.2%、3.1%;在临床糖尿病肾病组中,Cys-C、β2-MG和Ccr、SCr阳性率分别为89.2%、81.2%、60.7%、50%。Cys-C与β2-MG的相关系数r=0.8211,P<0.01,差异有显著性。结论通过检验数据分析,对血清Cys-C浓度与SCr、Ccr、β2-MG临床比较观察,胱抑素C用于评价糖尿病患者的肾功能状况,其特异性好于β2微球蛋白,灵敏度高于Ccr、SCr,是一个能较好反映肾小球滤过率的指标。

Objective To detect the serum cystatin C（Cys-C）,and serum creatinine（SCr）,creatinine clearance values in（Ccr）,β2 microglobulin（β2-MG）,the results were compared to evaluate their value on early diagnosis of kidney patients.Methods Particles enhance the immune turbidimetry measured in 50 healthy subjects and 100 diabetic patients with serum cystatin C,serum creatinine,β2-microglobulin concentrations,and 100 patients were measured urinary creatinine（UCr）,urinary microalbumin protein（MALB）and calculated the value of endogenous creatinine clearance and 24-hour urinary albumin.Results Early diabetic nephropathy Cys-C（1.61±0.82）,β2-MG（2.49±1.00）and clinical diabetic nephropathy group of Cys-C（2.27±1.16）,β2-MG（3.18±1.40）compared with of DM group Cys-C（0.90±0.19）,β2 MG（1.58±0.39）,and normal control group results were significantly higher,were significantly different（P0.01）; DM group Cys-C,β2-MG,SCr and Ccr test results and normal control group was not significant.Test data analysis showed that,in the early diabetic nephropathy group,Cys-C,β2-MG and Ccr,SCr positive rates were 71.8%,93.7%,31.2%,3.1%; in clinical diabetic nephropathy group,Cys-C,β2-MG and Ccr、SCr positive rates were 89.2%,81.2%,60.7%,50%.Cys-C and β2-MG in the correlation coefficient was r=0.8211,P0.01,significant difference.Conclusion According to the test data analysis,serum Cys-C levels and SCr,Ccr,β2-MG Comparison of clinical observation,evaluation of cystatin C for renal function in patients with diabetes status,and its specificity in β2 microglobulin,sensitivity was higher than Ccr,SCr,it can reflect an indicator of glomerular filtration rate.