糖尿病肾病患者HbA1c、Cys-C和β_2-MG早期联合检测的临床意义

The clinical significance of early combinational detection of HbAlc, Cys-C and β_2-MG in patients with diabetic nephropathy

目的研究HbA1c、Cys-C和β2-MG联合检测在2型糖尿病肾病早期的诊断价值。方法将94例糖尿病肾病患者随机分为无白蛋白尿组、微量白蛋白尿组和临床白蛋白尿组,对照组选取同期门诊健康体检者40例,比较4组间HbA1c、Cys-C和β2-MG水平变化。结果糖尿病肾病组患者HbA1c、Cys-C和β2-MG水平显著升高(P<0.05),其中微量白蛋白尿组和临床白蛋白尿组与对照组有显著性差异(P<0.01);HbA1c与Cys-C和β2-MG水平呈正相关(r=0.2763、0.4518,P<0.05);对照组HbA1c、Cys-C和β2-MG的综合阳性检出率为5.0%,而微量白蛋白尿组和临床白蛋白尿组的联合检测阳性率分别为88.6%和93.1%,联合检测的阳性率明显高于对照组(χ2=9.26,P<0.05),表明三项联合检测可提高2型早期糖尿病的检出率。结论 HbA1c、Cys-C与β2-MG与早期肾脏损伤程度密切相关,三者联合检测对DN的早期诊断、早期治疗及监测有着重要意义。

Objective To evaluate the diagnosis value of HbA1c, Cys-C, β2-MGG of early diagnosis in patients with diabetic nephropathy. Methods A total of 94 patients were divided into without albuminuria group, microalbuminuria group and clinical albuminuria group, selected health physical examination patient of 40 cases as control group, HbA1e,β2-MG,Cys-C were measured and compared with control group. Results HbA1c, Cys-C and β2-MG of patients with diabetic nephropathy group were significantly increased （P 〈 0.05）, microalbuminuria group and clinical albuminuria group had highly statistically significant （P 〈 0.01 ）compared with control group, levels of HbA1c, Cys-C and β2-MG were positively correlated （r = 0.2763,0.4518 ,P 〈 0.05）, HbA1c, Cys-C and β2-MG of control group＇s comprehensive positive detection rate was 5.0%, and the microalbuminuria group and clinical albuminuria group were 88.6% and 93.1% respectively, albuminuria group joint test positive rate were significantly higher than that of control group （x^2 =9.26,P 〈 0.05）, indicated that the three joint detection could improve detectable rate of early type 2 diabetes. Conclusion The HbA1c, Cys-C,β2-MG sensitive to early diagnosis and treatment of diabetes renal injury, test positive for joint detection rate is higher than the individual, it has important clinical value in the prevention and delay of diabetic nephropathy.