糖尿病患者测定视黄醇结合蛋白4和胱抑素C的意义

Detection of retinal-binding protein 4 and Cystatin C in patients with diabetes

目的:探讨多指标[血清胱抑素C(CysC),视黄醇结合蛋白4(RBP4)和尿RBP4、微量白蛋白(mALB)]联合检测对糖尿病早期肾损害的临床诊断价值。方法:采用病例对照研究,2型糖尿病患者155例(糖尿病组),对照组155例。比浊法检测血清CysC、RBP4,尿mALB和尿RBP4含量。结果:糖尿病患者血清CysC、RBP4、尿mALB和尿RBP4含量均比对照组有显著升高(P<0.01),多指标联用后以CysC+尿mALB检出率最高,为30.3%,其次为尿mALB+尿RBP4,为28.4%,三指标联用(CysC+血RBP4+尿mALB、血RBP4+尿mALB+尿RBP4)检出率都是32.3%,与两指标检测没有明显差异,但多指标联用较单指标检出阳性率显著提高(P<0.05)。结论:糖尿病患者应定期监测其肾功能损害程度,适当选择多指标联合检测可有效提高检出率。

Objective Discussion on the clinical diagnostic value of joint detection with multi-index （including serum Cys C, serum RBP4, urinary mALB and urinary RBP4）in early diabetic renal damage to improve the detection rate of renal damage. Method Case control study was used and 155 cases with type 2 diabetes in treatment group and 155 healthy cases in control group. Turbidimetry was used to test content of serum Cys C, serum RBP4, urinary mALB and urinary tlBP4. Results Serum Cys C, serum RBP4, urinary mALB and urinary RBP4 levels in diabetes were significantly higher than those in control group （P 〈 0.01）, the detection rate of combined with the muhi^index （Cys C ＋ urinary mALB） was the highest （up to 30.3%）, the second was urinary mALB ＋ urinary RBP4, 28.4%. The detection rate of combined with three indicators （Cys C ＋ serum RBP4 ＋ urinary mALB and serum RBP4 ＋ urinary mALB ＋ urinary RBP4） was both 32.3%. There was no significant difference than two targets, but the detection rate of the multi-index was signifieantly increased than single indicator rate （P 〈 0.05）. Conclusion Cases with diabetes should regularly monitor damage level of kidney function and appropriate selection of joint detection with multi-index can be helpful for diagnosis.