CysC、α1-MG和β2-MG在糖尿病早期肾损伤诊断中的价值

The vlue of CysC,α1-MG and β2-MG in the erly diaghosis dabetic nphropathy

目的探讨血清胱抑素C(CysC)、α1微球蛋白(α1-MG)和β2微球蛋白(β2-MG)多指标检测在糖尿病早期肾损伤中的诊断价值。方法选取糖尿病(DM)患者188例和健康对照者90例,检测各组血CysC、α1-MG、β2-MG、BUN和Cr的含量并作统计分析。结果单纯DM组血清CysC、α1-MG水平较健康对照组明显升高(P<0.05),但两组β2-MG、BUN和Cr水平无明显差异;早期DN组血清CysC、α1-MG和β2-MG水平较单纯DM组显著升高(P<0.01),但两组血清BUN、Cr水平无明显差异;188例糖尿病患者血清CysC、α1-MG和β2-MG均与BUN、Cr水平呈正相关;早期DN组中3个指标的异常率较单纯DM组显著升高;3个指标联合检测早期肾损伤的异常率较单指标检测明显升高;用ROC曲线进行诊断效能评价,以CysC最优。结论血清CysC、α1-MG和β2-MG联合检测可发现糖尿病病程中的早期肾损伤,有重要的临床应用价值。

Objective To investigate the clinical value of cystainC（CysC） ,α1-microglohublin（α1-MG） and β2-microglohublin（β2- MG） for the early diabetic nephropathy（DN）. Methods 188 cases of patients with diabetes mellitus were divided into β2 groups ac- cording to the urinary albumin to creatinine ratio（ACR）. In addition, there was a healthy control group including 90 cases of healthy individuals. CysC, α1-MG, β2-MG, serum creatinine（Cr） and blood urea nitrogen（BUN） of all cases were measured, compared and analyzed. Results Between diabetes mellitus（DM） group and control group, the levels of CysC and α1-MG had significant differ- ence,but the levels of β2-MG,BUN and Cr had no difference. In DM and DN group,CysC,α1-MG and β2-MG had positive correla- tion with BUN and Cr. Between DN group and DM group,the levels of CysC,α1-MG and β2-MG had significant difference,but the levels of BUN,Cr had no difference. The abnormal rates in DN group of CysC, α-MG and β2-MG were evidently higher than those in DN group. The abnormal rates in combined examination of CysC, α1-MG and β2-MG were evidently higher than one of them. Di- agnosis effects of three indicators were analyzed by ROC curve. The areas under ROC curves indicate that CysC was a superior indi- cator. Conclusion Combined detection of Cyst and α1-MG,β2-MG is helpful for early diagnosis of renal damage in the course of di- abetic mellitus,which will be a assistant way to forecast the DN.