血清胱抑素C在糖尿病、高血压早期肾损害诊断中的价值

Application value of serum cystatin C for diagnosing early kidney injury of diabetes and hypertension

目的 通过对2型糖尿病和原发性高血压患者进行血清胱抑素C（CysC）、肌酐及尿微量白蛋白排泄量（UAE）的检测,评估CysC在糖尿病和高血压早期肾损害诊断中的价值.方法 选择2型糖尿病患者66例,其中38例UAE在30 ～ 300 mg/24 h的患者归入早期糖尿病肾病（DN）组,28例UAE＜ 30 mg/24 h的患者归入无肾病的糖尿病（NDN）组;原发性高血压患者52例,其中25例UAE≥30 mg/24 h的患者归人高血压肾损害组,27例UAE＜ 30 mg/24 h的患者归入高血压无肾损害组;60例健康成年人为对照组.所有入选者检测UAE、CysC、肌酐含量.结果 早期DN组CysC显著高于对照组和NDN组[（1.84±0.83） mg/L比（0.41 ±0.62）,（0.66 ±0.59） mg/L],差异有统计学意义（P＜ 0.05）;而NDN组CysC与对照组比较差异无统计学意义（P＞0.05）;三组肌酐和UAE比较差异均无统计学意义（P＞0.05）.高血压肾损害组CysC显著高于对照组和高血压无肾损害组[（0.93±1.04） mg/L比（0.41±0.62）,（0.69±0.57） mg/L],差异有统计学意义（P＜0.05）;而高血压无肾损害组CysC与对照组比较差异无统计学意义（P＞0.05）;三组肌酐和UAE比较差异均无统计学意义（P＞0.05）.结论 CysC可作为判断早期肾损害的指标,对患者病情进展有很好的了解,及时采取治疗措施,可降低和避免慢性肾衰竭的发生.

Objective To evaluate the significance of cystatin C （CysC） in the diagnosis for early kidney injury of diabetes and hypertension by testing serum CysC and serum creatinine concentration and urinary albumin excretion （UAE） in patients with type 2 diabetes and primary hypertension.Methods Sixty-six patients with type 2 diabetes were selected,among whom the total 38 patients whose UAE were 30-300 mg/24 h were classified into early diabetic nephropathy （DN） group,and 28 patients whose UAE were 〈 30 mg/24 h were classified into non diabetic nephropathy （NDN） group.Fifty-two patients with primary hypertension were selected,among whom the total 25 patients whose UAE were ≥ 30 mg/24 h were classified into hypertension with kidney injury group,and 27 patients whose UAE were 〈 30 mg/24 h were classified into hypertension without kidney injury group.Sixty health people were selected as control group.The UAE,CysC and creatinine levels were detected.Results The CysC in early DN group was significantly higher than that in control group and NDN group [（1.84 ± 0.83）mg/L vs.（0.41 ± 0.62） and （0.66 ± 0.59） mg/L],and there was statistical difference （P 〈 0.05）.There was no statistical difference in CysC between NDN group and control group （P 〉 0.05）.There were no statistical differences in creatinine and UAE among the DN group,NDN group and control group （P 〉 0.05）.The CysC in hypertension with kidney injury group was significantly higher than that in control group and hypertension without kidney injury group [（0.93 ± 1.04） mg/L vs.（0.41 ± 0.62） and （0.69 ± 0.57） mg/L],and there was statistical difference （P 〈 0.05）.There was no statistical difference in CysC between hypertension without kidney injury group and control group （P 〉 0.05）.There were statistical differences in creatinine and UAE among hypertension with kidney injury group,hypertension without kidney injury group and control group （P 〉 0.05）.Conclusion CysC can be regarded as the value to judge early kidney injury,and it is very important inunderstanding patient＇s condition,by which appropriate treatment can be carried out to prevent or decrease the occurrence of chronic renal failure.