D二聚体、胱抑素C在糖尿病早期肾功能损伤诊断的临床研究

Clinical studies on D-dimer, cystatin C in elderly diabetic diagnosis of early renal damage

目的 研究D-二聚体（D-D）、胱抑素C（Cys C）对糖尿病患者肾功能监测的临床应用价值.方法 比较糖尿病患者中肾功能正常（62例）、肾功能不全代偿（57例）、肾功能不全失代偿（49例）患者D-D及Cys C检测情况,研究D-D及Cys C与肾小球滤过率（glomerular filtration rate,GFR）相关性,对D-D及Cys C对糖尿病患者早期肾损伤诊断进行方法学评价.结果 肾功能不全失代偿组肌酐（Cr）与正常对照组、肾功能正常组及肾功能不全代偿组比较均有统计学差异（P＜0.05）,肾功能不全代偿组、肾功能正常组及正常对照组3组组间Cr比较均无统计学差异（P＞0.05）;肾功能正常组及正常对照组D-D、Cys C比较均无统计学差异（P＞0.05）,其他任意两组比较均有统计学差异（P＜0.05）;D-D（r=-0.526,P＜0.05）及Cys C（r=-0.734,P＜0.05）与GFR均呈负相关,相关系数CysC高于D-D;方法学评价D-D及CysC有较高的灵敏度、特异度、符合率及约登指数.结论 D-D及Cys C在肾功能监测方面有较高的灵敏度,对糖尿病患者肾损伤早期诊断有重要的临床应用价值.

Objective To study the D-dimer （DD）, cystatin C （Cys C） on renal function in dia- betes patients monitoring clinical applications. Methods Compared D-dimer and Cys C test case in dia- betic patients with normal renal function group （62 cases）, renal insufficiency compensation group （57 cases）, renal insufficiency, decompensated group （49 cases） of patients, and researched D-dimer and Cys C and glomerular filtration rate （GFR） correlation, evaluation D-dimer and Cys C in diabetic pa- tients with early diagnosis of renal injury methodological evaluation. Results Cr decompensated renal dysfunction group compared with the other three groups were statistically significant （P0. 05）, re- nal insufficiency, decompensated group with normal renal function group and normal control group had no significant difference between the three groups （P0. 05） ; DD, Cys C with normal renal function group and normal control group were not statistically different （P0. 05）, any other two groups were statistically significant （P0. 05） ; DD （r = - 0. 526,P0. 05） and Cys C （r = - 0. 734, P0. 05） and GFR was negatively correlated Cys C higher than DD; methodological evaluation DD and Cys C had high sensitivity and specificity degrees, the compliance rate and Youden indem Conclusions D-di- met, and cystatin C in renal function monitoring has higher sensitivity for early diagnosis of renal inju- ry in diabetic patients has important clinical value.