血清半胱氨酸蛋白酶抑制剂C和尿微量白蛋白在糖尿病肾病中的诊断价值

The diagnostic value of serum cystatin C and urinary microalbumin in early diabetic nephropathy

目的检测各型糖尿病肾病患者血清中半胱氨酸蛋白酶抑制剂C(Cys C)、尿微量白蛋白(U-mAlb)的水平,以探讨其临床应用价值。方法把2型糖尿病患者分为单纯糖尿病组(DM组)、早期糖尿病肾病组(EDN组)、临床糖尿病肾病组(DN组),并以健康体检者作为对照组,采用Beckman-Coulter公司LX-20全自动生化分析仪分别检测血清中的Cys C、Scr的水平;U-mAlb采用美国Beckman-Coulter公司IMMAGE全自动免疫比浊仪检测。数据以均数±标准差(x±s)表示,应用SPSS 13.0版软件包进行统计分析,组间比较采用t检验,P<0.05为差异有统计学意义。结果在2型糖尿病患者中,血清中的Cys C与U-mAlb呈正相关,随病情的发展明显升高;Cys C各组相比均是P<0.01。U-mAlb:DN组与各组相比,P均<0.01,END组与DM组、对照组相比,P均<0.01。Scr:EDN组与对照组相比,P<0.01,DN组与DM组、对照组相比,P均<0.01。结论 Cys C与U-mAlb联合检测是诊断糖尿病早期肾损害非常敏感而又实用的指标。

Objective To evaluate the diagnostic value of serum cystatin C（Cys C） and urinary microalbumin（U-mAlb） in early diabetic nephropathy.Methods Type 2 diabetic patients included pure diabetes mellitus（DM）,early diabetic nephropathy（EDN） and clinical diabetic nephropathy（DN） groups.Beckman-coulter Lx-20 automatic biochemical analyzer and IMMAGE automatic immunoturbidimetric analyzer were used to detect serum Cys C,serum creatinine（Scr） and U-mAlb respectively.Results The concentrations of serum Cys C and U-mAlb were positively correlated with the disease development in type 2 diabetic patients（P0.01）.There was significant difference in the concentration of serum Cys C,which was the highest in the group of DN,and followed by the groups of END,DM and healthy controls subsequently（P0.01）.There was no difference in the concentrations of mAlb between the groups of DM and healthy reference controls.However,the concentrations of mAlb were significantly increased in the groups of DN and END.The concentration of creatinine was higher in DN group than that in any other groups（P0.01）.Conclusion The detection of Cys C and mAlb is very sensitive and useful for the diagnosis of DM and early renal damage.