血清胱抑素C测定对糖尿病肾病的早期诊断价值

Value of the Measurement of Serum Cystatin C in Early Diagnosis of Diabetic Nephropathy

[目的]探讨血清胱抑素C（Cys-C）对糖尿病肾病（DN）早期的诊断价值.[方法]随机选择86例住院2型糖尿病（T2DM）患者和35例健康体检者作为研究对象,并根据尿微量白蛋白排泄率（UAER）将86例患者分成三组.A组：UAER＜20 μg/min,共38例;B组：UAER 20～200 μg/min,共28例;C组：UAER＞200 μg/min,共20例.利用东芝TBA-120FR检测研究对象的血清Cys-C、血清尿素（Urea）、肌酐（SCr）和尿UAER.[结果]与对照组比较,A组血清Cys-C、Urea和SCr变化不显著（P＞0.05）;B组血清Cys-C水平轻度升高（P＜0.05）,而Urea和SCr无明显变化（P＞0.05）,C组的Cys-C与对照组、A组和B组比较,差异有统计学意义（P均＜0.01）,而Urea和SCr的值无统计学意义（P＞0.05）.随着尿UAER的升高,血清Cys-C水平亦随之升高（P＜0.01）.

[Objective] To explore the value of the measurement of serum cystatin C in early diagnosis of diabetic nephropathy（DN）. [Methods] Totally 86 inpatients with type 2 diabetes mellitus（T2DM） and 35 normal persons were randomly enrolled in the study. According to urinary albumin excretion rate（UAER）, all the 86 patients were divided into group I（UAER〈20μg/min, n = 38）, group Ⅱ（UAER 20-200 μg/min, i.e. recessive DN, n = 28） and group Ⅲ （UAER〉200 μg/min,i. e. dominant DN, n=20）. Serum Cys-C, Urea, creatinine（Scr） and urine UAER of all research objects were measured by TBA-120FR. [Results] As compared with control group, the changes of serum Cys-C, Urea and Scr in group I were not significant（p〉0.05）. In group Ⅱ, serum Cys-C slightly increased（ P〈0.05）, but the chan ges of Urea and Scr were not significant（ P 〉0.05）. There was significant difference in serum Cys-C between group Ⅲ and control group, group I and group Ⅱ（all P 〈0.01）, but there was no significant difference in Urea and Scr（ P〉 0.05）. With the increasing of UAER, serum Cys-C elevated（ P 〈0.01）. [Conclusion] Serum Cys-C is of great value for early diagnosis of DN.