CTGF，胱抑素C和尿β2-MG联合检测在糖尿病肾病早期病变中的诊断价值

Diagnostic Value of Combined Detection of Serum CTGF, Cys-C and Urine β2-MG Detection in Early Diabetic Nephropathy

目的探讨血清结缔组织生长因子（CTGF）、胱抑素C（Cys—C）和尿β2-MG联合检测在糖尿病肾病（DN）早期肾功能损害的诊断价值。方法2009年6月～2011年6月间，老河口市第一医院内分泌科收治的2型糖尿病患者按尿清蛋白排泄率（UAER）分为A，B，C三组：A组为正常蛋白尿组32例（UAER〈20μg／min），B组为微量蛋白尿组31例（20μg／min≤UAER≤200μg／min），C组为大量蛋白尿组31例（UAER〉200μg／min）；同时选择该院进行体检的健康群体30例作为对照，测定各组的CTGF，Cys-C和β2-MG，应用Pearson’s相关性分析和ROC曲线分析对各指标进行评价。结果糖尿病患者的CTGF，Cys-C和β2-MG明显高于对照组（P〈0．05）；糖尿病患者的CTGF，Cys—C和β2-MG水平与UAER呈显著正相关（r=0．81，0．34，0．41，P〈0．05）；CTGF，Cys—C和β2-MG联合诊断的ROC曲线下面积大于各指标单独诊断。结论糖尿病患者CTGF，Cys—C和β2-MG水平的升高与其早期肾损伤的发生密切相关，联合应用可以提高DN早期肾损伤诊断的准确性。

Objective To explore the diagnostic significance of serum CTGF,cystatin C （Gys C） ,and urine β2-MG detection in the early stage renal damage in Diabetes. Methods June 2009-June 2011,According to urinary albumin excretion rate （UAER） ,94 cases diabetic patients were divided into 3 groups. A group was 32 cases of patients with microalbuminuria （UAER-20 μg/min） ,B Group was 31 cases of patients with substantial proteinuria （UAER20-200 μg/min） ,C group was 31 cases of patients with microalbuminuria （UAER-200 μg/min）,while the contral group was 30 healthy persons without diabetes. Serum CTGF, Cystatin C, and urine β2-MG were measured in each group. Evaluated the various indicators by Pearson＇s correlation analysis and ROC curve analysis. Results In patients with diabetic nephropathy,CTGF,Cys C and β2-MG on average were higher than that in patients without diabetes （P〈0.05） ,and they were higher in B and C group than that in A group（P〈0.05）. In DM patients,CTGF,Cys-C and β2-MG was positively correlated with UAER （r=0. 81,0. 34,0. 41, P〈0.05）. ROC areas of combined examination were more than every one. Conclusion CTGF,Cys-C and β2-MG were the sensitive indicators to diagnosis early stage clinical diabetic nephmpathy. Combined examination can have more practical value.