肾小球滤过功能检测在糖尿病肾病中的诊断价值

Diagnostic value of glomerular filtration function detection for diabetic nephropathy

目的探讨血清胱抑素C(Cys-C)、血清肌酐(Scr)、尿素(Urea)和肌酐清除率(Ccr)在糖尿病肾病患者中的早期诊断价值。方法将128例2型糖尿病患者按24h尿微量白蛋白水平分为3组,A组为正常蛋白尿患者49例(UMA<30mg/24h),B组为微量蛋白尿患者45例(UMA30～300mg/24h),C组为大量蛋白尿患者34例(UMA>300mg/24h或常规蛋白阳性),测定血清胱抑素C(Cys-C)、血清肌酐(Scr)、尿素氮(Urea),并计算肌酐清除率(Ccr)。结果血清胱抑素C(Cys-C)在各组间差异有统计学意义(P<0.01);而Scr、Urea、Ccr在A组和B组间差异无统计学意义(P>0.05);C组的Scr、Urea、Ccr高于A组和B组,差异有统计学意义(P<0.01)。结论血清胱抑素C是糖尿病肾病早期诊断的敏感指标。

Objective To explore the value of serum cystatin-C, serum creatinine（Scr）, urea and creatinine clearance rate （Ccr） in the early diagnosis of diabetic nephropathy. Methods According to urine microalbum of 24 hours, 128 patients with type 2 diabetes were divided into 3 groups. A group had 48 patients with normal albumiuria, B group had 45 patients with microalbumiuria, C group had 34 patients with macroalbumiuria. Serum cystatin-C, serum creatinine and urea were measured, and creatinine clearance rate were calculated. Results Serum cystatin-C was different among the three groups（P 0.01）, but serum creatinine, Urea, and creatinine clearance rate were not different between A group and B group, serum creatinine, urea and creatinine clearance rate of C group were higher than A group and B group. Conclusion Serum cystatin-C is a sensitive parameter in diagnosing early diabetic nephropathy.