D-二聚体、胱抑素C在早期糖尿病肾病诊断中的临床价值

Clinical value of D dimer and cystatin C in the diagnosis of early diabetic nephropathy

目的探讨D-二聚体(D-D)、血清胱抑素C(Cys C)在早期糖尿病肾病(DN)诊治中的临床价值。方法将94例2型糖尿病(T2DM)患者,根据24小时尿微量清蛋白排泄率(UAER)分为单纯糖尿病组(SDM组)30例,早期糖尿病肾病组(EDN组)32例,糖尿病肾病组(CDN组)32例;另选30名健康体检者作为对照组,分别检测各组中血D-D、血清Cys C,对各组检测结果进行比较,并进行相关分析。结果四组血清D-D、Cys C、UAER比较差异均有统计学意义(P<0.01),进一步两两比较发现,EDN组和CDN组的血清D-D、Cys C、UAER均显著高于SDM组和对照组(P<0.01),CDN组的血清D-D、Cys C、UAER又显著高于EDN组(P<0.01)。采用直线回归分析D-D、Cys C与UAER的关系,结果D-D、Cys C与UAER均成正相关,相关系数分别为0.392和0.786。结论血浆D-D、血清Cys C水平随着DN的发展而逐渐升高,两者在早期糖尿病肾病的诊断中有重要临床价值。

Objective To investigate the clinical application value of D dimer （D-D）and cystatin C（Cys C）in the early diagnosis and treatment of diabetic nephropathy（DN）. Methods 94 cases with type 2 diabetes mellitus （T2DM） were divided into 3 groups according to their 24-hour urinary albumin excretion rates of trace. These groups included the simple diabetic mellitus （SDM） group （30 cases）, early diabetic nephropathy（EDN）group（32 cases）, and clinical diabetic nephropathy （CDN） group（32 cases）. And 30 healthy people were selected as the control group. The D-D and Cys C of each group were detected, he data was compared and given correlation analysis. Results There were statisti- cal difference in levels of D-D,CysC,UAER of the four groups（ P 〈0.01）. Further comparison showed that levels of D-D and Cys C of the EDN group and the CDN group were obviously higher than those of the SDM group and the con- trol group（ P 〈0. 01）. And levels of all these indexes of the CDN group were higher than those of the EDN group（ P〈0.01）. Analysis of linear regression revealed that D-D,CysC and UAER were positively correlated and their corre- lation coefficients were 392 and 0. 786. Conclusion Plasma D-D,serum Cys C levels of patients gradually increase with the development of DN. They have important clinical value in the early diagnosis of diabetic nephropathy.