血清胱抑素C、同型半胱氨酸及C-反应蛋白在糖尿病肾病早期诊断中的价值探讨

The value of serum cystatin C,homocysteine and C-reactive protein in early diagnosis of diabetic nephropathy

目的:探讨血清胱抑素C(cystatin C,CYS-C)、同型半胱氨酸(homocysteine,Hcy)、C反应蛋白(C-reactive protein,CRP)在早期糖尿病肾病(Diabetic Nephropathy,DN)诊断中的意义。方法:收集糖尿病患者78例,根据尿白蛋白排泄率(UAER)分为正常蛋白尿组(A组)27例、微量蛋白尿组(B组)34例和大量蛋白尿组(C组)17例;对78例糖尿病患者及健康对照组36例进行CYS-C、Hcy、CRP等生化指标检测。结果:CYS-C在糖尿病组均有明显升高,并且随着病情的加重,血清CYS-C、Hcy、CRP水平逐渐升高;对照组的CYS-C、Hcy、CRP与A、B、C组中的比较均有明显统计学意义(P<0.05),正常蛋白尿组血CYS-C、Hcy、CRP水平与对照组相比有显著性差异(P<0.05);B组和C组血清CYS-C、Hcy、CRP水平明显高于对照组和C组,且以C组更为显著(P<0.05)。结论:血清CYS-C、Hcy、CRP可以作为早期糖尿病肾病诊断的参考指标。

Objective： To discuss the significance of the serum cystatin C （ CYS - C ）, Homocysteine （Hcy） and C - reactive protein （CRP） in early diagnosis of diabetic nephropathy. Methods：According to urinary albumin excretion rate ,78 patients with diabetes were divided into the normal al- buminuria group（ group A ,27 cases）, the microalbuminuria group（ group B ,34 cases） and the macroalbuminuria group（ group C, 17 cases） ;selected the same 36 healthy subjects as the control group; detection of CYS - C, Hcy, CRP and other biochemical indicators. Results： CYS - C were significantly higher in the diabetic group, and as the disease worsens, serum CYS - C, Hcy, CRP levels increased gradually; there were significant differences on CYS - C, Hey and CRP between control group and diabetic group（ P 〈 0.05 ）, there were significant differences on CYS -C, Hcy and CRP between normal albuminufia group and control group （P 〈 0.05 ） ; group B and group C serum CYS -C, Hcy, CRP levels were significantly higher than those in the control group and group A, and group C was more significant（ P 〈 0.05 ）. Conclusion ： CYS -C, Hcy, CRP can be used for reference indexes in early diagnosis of diabetic nephropathy.