血清胱抑素C浓度在Ⅱ型糖尿病肾病早期诊断中的临床价值

Clinical significance of detection of serum Cystatin C in early stage of diabetic nephropathy

目的探讨血清胱抑素C(Cys-C)浓度在Ⅱ型糖尿病肾病早期诊断中的临床价值,寻求肾小球滤过率的理想标志物。方法根据尿白蛋白排泄率将92例糖尿病肾病早期患者分为:临床蛋白尿组(A组)、微量蛋白尿组(B组)和正常蛋白尿组(C组)3组,以30例健康体检者为对照组,采用乳胶颗粒散射比浊法检测Cys-C、酶法测定血肌酐(Scr)、尿肌酐(Ucr),尿素酶法测定尿素氮(BUN)和计算肌酐清除率(Ccr)等指标。结果对照组Cys-C的浓度均低于A、B、C三组,差异均具有统计学意义(P<0.05),且Cys-C浓度随着病情加重逐渐升高;A组的Cys-C、Scr、BUN和Ccr分别与B、C两组比较,差异具有统计学意义(P<0.05)。结论血清Cys-C在糖尿病肾病早期检出较高,是反映肾小球滤过率的理想标志物,对糖尿病肾病早期诊断具有重要意义。

Objective To study the clinical significance of detecting serum level of Cystatin C in early diagnosis of diabetic nephropathy in patients with type II diabetes,and to find out ideal markers for glomerular filtration rate.Methods According to the idea of Chung,urinary albumin excretion rate is important in classification,92 patients with typeⅡdiabetes are divided into 3 groups： clinical proteinuria group（group A）,microalbuminuria group（group B） and negative albuminuria group（group C）.Thirty healthy persons are selected as control group.Serum level of Cys-C is detected by latex particle enhanced immunoturbidimetric assay,and serum levels of Scr and Ucr are detected by enzymic method,and serum level of BUN is detected by urease-berthelot method.Their creatinine clearance rates（Ccr） are calculated and analyzed.Results Serum level of Cys C in diabetic nephropathy group is significantly higher than that of control group（P0.05）.Serum levels of Cys C,Scr and BUN and Ccr in patients of group A are higher than those of patients in groups B and C（P0.05）.Conclusion The detection rate of serum Cys C is high in early stage of diabetic nephropathy.Serum level of Cys C is an ideal serological marker for detecting early renal impairment in patients with diabetes.