糖尿病肾病患者血清胱抑素C检测的临床意义

Clinical significance of detecting serum cystatin C in patients with diabetic nephropathy

目的探讨检测糖尿病肾病患者血清胱抑素C(Cys-C)水平的临床意义。方法根据24-h尿微量白蛋白排泄率(UAE),将2型糖尿病(T2DM)患者80例分为无蛋白尿(A组,36例,UAE<30mg/L)和微量蛋白尿(B组,44例,UAE 30-300mg/L)两组,另选30例体检健康者作为对照(C组),采用免疫比浊法检测血清Cys-C,生化分析仪检测血肌酐(SCr)。结果 A组血清Cys-C和SCr分别为(0.95±0.46)mg/L和(95.54±16.21)μmol/L,明显低于B组的(1.14±0.73)mg/L和(101.42±13.46)μmol/L(P<0.05);A、B组血清Cys-C和SCr均明显高于C组的(0.63±0.07)mg/L和(55.54±10.05)μmol/L(P<0.05)。A组血清Cys-C和SCr异常检出率均明显低于B组(19.44%vs.40.91%和2.78%vs.9.09%)(P<0.05);A、B组Cys-C异常检出率均明显高于SCr异常检出率(P<0.05)。结论糖尿病肾病患者血清Cys-C水平升高;与SCr比较,检测血清Cys-C更有助于糖尿病肾病的早期诊断。

Objective To investigate the clinical significance of detecting serum cystatin C （Cys-C） in patients with diabetic nephropathy. Methods On the basis of 24-h urinary albumin exeretion（UAE）, 80 patients with type 2 diabetes mellitus（T2DM） were divided into two groups of A （36 eases with UAE〈30 mg/L） and B（44 cases with UAE 30-300 mg/L）. Another 30 healthy people were taken as the controls（group C）. Serum levels of Cys-C and creatinine（SCr） were detected with latex-enhanced immune serum projected nephelometry detection and automatic biochemical analyzer. Results Serum levels of Cys-C and SCr were （0. 95±0.46） mg/L and （95.54± 16.21） μmol/L in group A,which were lower than （1.14±0. 73） mg/L and （101.42± 13.46） tLmol/L in group B （P〈0. 05）. Serum levels of Cys-C and SCr were higher in groups of B and A than （0. 63±0. 07） mg/L and （55.54±10.05） μmol/L in group C（P〈0. 05）. The positive detection rates of serum Cys-C and SCr were lower in group A than those in group B（19.44% vs. 40.91% and 2.78% vs. 9.09%） （P〈0.05）. The positive detection rate of serum Cys-C was significantly higher than that of SCr in groups of B and A（P〈0. 05）. Conclusion Serum level of Cys-C is remarkably elevated in the patients with diabetic nephropathy. Detection of serum Cys-C is better than that of SCr in the early diagnosis of diabetic nephropathy.