血清胱抑素C在2型糖尿病肾病早期诊断中的价值

Diagnosis Value of Serum Cystatin C in the Early Nephropathy Induced by Type 2 Diabetes Mellitus

目的:探讨血清胱抑素C(CysC)在2型糖尿病肾病早期诊断中的价值,为临床治疗提供依据。方法:收集符合标准的2型糖尿病患者200例,根据尿白蛋白排泄率(UAER)将患者分为三组,即正常蛋白尿组48例、微量蛋白尿组91例和临床蛋白尿组61例,检测血清中CysC水平。结果:正常蛋白尿组血清CysC水平及UAER最低,临床蛋白尿组最高,三者之间比较,差异有显著性(P<0.05)。微量蛋白尿组与临床蛋白尿组血清CysC浓度与UAER呈显著正相关(r分别为0.081,0.670,P<0.05)。血清CysC诊断糖尿病肾病的灵敏度87.5%(133/152),特异度为93.75(45/48)。结论:血清CysC与2型糖尿病患者的早期肾损伤程度密切相关,具有较高的灵敏度与特异度,为糖尿病肾病早期诊断提供重要信息。

Objective：To investigate the value of serum cystatin C （CysC） in the early diagnosis of ne-phropathy induced by type 2 diabetes mellitus and to provide foundations for clinical treatment .Method：200 eligible patients with type 2 diabetes mellitus were collected and divided into 3 groups according to urine al-bumin excretory rate （ UAER） , namely, 48 patients in normal albuminuria group , 91 cases in microalbumin-uria group and 61 cases in clinical proteinuria group;the serum CysC levels were determined .Result： The CysC level and UAER of the normal albuminuria group were the lowest , while those of the clinical proteinuria group were the highest , and the difference among three groups was statistically significant （ P＆lt;0.05） .The se-rum Cys C concentrations of the microalbuminuria group and the clinical proteinuria group were significantly positively correlative with UAER （ r =0.081 and 0.670 respectively , P＆lt;0.05） .The sensitivity of serum Cy-sC in diagnosis of diabetic nephropathy was 87.5%（ 133/152 ） , and the specificity was 93.75 （ 45/48 ） . Conclusion：Serum CysC is closely related with early kidney injury degree in patients with type 2 diabetes mellitus , has high sensitivity and specificity , and can provide important information for early diagnosis of dia-betic nephropathy .