糖尿病肾病患者早期检测指标应用价值研究

The value of sensitive indicators in early detection of diabetic nephropathy

目的探讨糖尿病肾病(diabetes nephropathy,DN)患者早期检测指标的应用价值。方法选取2012年7月—2013年10月收治的2型糖尿病(diabetes mellitus,DM)患者126例为DM组,根据24 h尿白蛋白排泄率(the 24 h urinary albumin excretion rate,UAER)将患者分为三组:SDM组33例、EDN组57例、CDN组36例,正常对照组(NC组)55例为同期来体检中心的健康体检者。定量检测CysC、Hcy、hs-CRP、U-mALB的浓度和阳性率,并将其结果与NC组进行比较。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 DM组CysC、Hcy、hs-CRP、U-mALB水平[(1.95±0.34)mg/L、(21.26±7.13)μmol/L、(5.31±2.25)、(352.67±113.58)mg/L]均明显高于对照组[(0.83±0.19)mg/L、(9.06±3.24)μmol/L、(0.85±0.23)、(10.53±4.11)mg/L],比较差异均有统计学意义(均P<0.05)。随着肾功能损伤的加重CysC、Hcy、hs-CRP、U-mALB水平均明显增加,差异均有统计学意义(均P<0.05)。患者CysC、Hcy、hs-CRP、U-mALB指标阳性率随DN的加重而增加,且联合检测阳性率均较单项指标检测高。结论联合检测糖尿病患者CysC、Hcy、hs-CRP、U-mALB可作为诊断DN早期肾损害的可靠敏感指标。

Objective To explore the value of sensitive indicators in early detection of diabetic nephropathy.Methods A total of126 cases of type 2 DM treated from July 2012 to October 2013 were divided into three groups according to their 24h-urinary albumin excretion rate（UAER）,including SDM group（n=33）,EDN group（n=57）,CDN group（n=36）.Fifty-five cases of healthy people were as the normal controls（group NC）.All groups were detected quantitatively for the level of CysC,Hcy,hs-CRP,and U-mALB as well as the positive rate.Measurement data were processed by t test,count data by χ2test,the result of P0.05 was significantly different.Results The level of CysC,Hcy,hs-CRP and U-mALB were（1.95±0.34）mg/L,（21.26±7.13）μmol/L,（5.31 ±2.25）mg/L,and（352.67±113.58）mg/L respectively in group DM,which was significantly higher than that in control group [（0.83 ±0.19）mg/L,（9.06±3.24）μmol/L,（0.85±0.23）,（10.53±4.11）mg/L],showing significantly difference（P0.05）.The level of CysC,Hcy,hs-CRP and U-mALB increased significantly with the severity of renal injury,the difference was statistically significant（P0.05）.The positive rate of CysC,Hcy,hs-CRP,U-mALB increased with the severity of DN,and the combined detection of indicators showed a higher positive detection rate than the detection of a single indicator.Conclusion Combined detection of CysC,Hcy,hs-CRP U-mALB in diabetic patients can be used as a sensitive and reliable indictor for the early diagnosis of renal damage in DN.