2型糖尿病肾病患者血清胱抑素C水平检测的临床价值

Clinical significance of serum cystatin C in patients with type 2 diabetes nephropathy

目的探讨2型糖尿病(DM)患者检测血清胱抑素C(CysC)水平对糖尿病肾病(DN)的临床应用价值。方法检测120例DM患者和100例健康对照组血清胱抑素C(CysC)、肌酐(Cr)、微量白蛋白(mALB)、糖化血红蛋白(HbA1c),肾小球滤过率估计值(eGFR)等指标,并观察DN患者血清CysC与各指标之间的相关关系。结果尿mALB在DN早期即可升高,且随病情发展而进一步升高(P<0.01);随着DM尿mALB增加,糖化血红蛋白(HbA1c)水平逐渐增加(P<0.05);DM组血清CysC,IL-18水平明显高于对照组,DN组又DM组,EDN组进一步升高(P<0.01);血清CysC与SCr、mALB排泄量、HbA1c呈正相关(r=0.661,0.652,0.589,P<0.05),与eGFR呈负相关(r=-0.667,P<0.01)。结论 DN患者血清CysC水平增高,并与病情进展有关;DN患者血清CysC与SCr、mALB排泄量、HbA1c呈正相关,与eGFR呈负相关。血清CysC是发现2型DM早期肾损伤有价值的实验室指标,值得临床推广应用。

Objective To explore the clinical significance of serum cystatin C levels in type 2 diabetic nephropathy. Methods To test the plasma levels of Cys C, Cr, mALB, HbAlc and eGFR in 120 patients and 100 normal controls, and to observe the relationship between Cys C and these indexs. Results urine mALB level went high in early DN and rose as the state of illness developed（P 〈0. 01 ）. As urine mALB went up in DM patients, level of HbA1 c increased increasingly （P 〈 0. 05 ）. Serum levels of Cys C, IL-18 in DM group were higher significantly than control group and DM group was higher than DN group. EDM group was further higher （ P 〈 0. 01 ）. Serum levels Cys C was positive correlation with SCr mALB＇s evacuation and HbAlc （ r = 0. 661, 0. 652,0. 589, P 〈 0. 05 ） and was negative correlation with eGFR （ r = 4）. 667, P 〈 0. 01 ）. Conclusion Serum levels of Cys C＇ s rise with DM patients were related with the development of state of illness. Serum levels of Cys C with DN patients was positive correlation with SCr mALB＇s evacuation and HbA1 c and was negative correlation with eGFR. Serum Cys C was a valuable laboratorial parameter on discovery of early type 2 diabetes nephropathy and it＇s deserved to popularize in clinical.