血清胱抑素C及相关指标联合检测对糖尿病早期肾损害的临床价值

Role of serum cystatin C and related indicators in diagnosis of early renal damage in diabetes patients

目的:探讨血清胱抑素C(Cys C)及相关指标检测对糖尿病早期肾损害的诊断价值。方法:采用胶乳增强免疫比浊法、酶法及免疫比浊法分别用Beckma AU5400型、贝克曼IMMAGE 800型检测糖尿病组50例和对照组30名血Cys C、尿素、肌酐、肾小球滤过率及尿微量白蛋白(U-Alb),对2组检测结果进行比较。结果:糖尿病组Cys C、U-Alb、尿素检测结果均明显高于对照组(P<0.01);糖尿病组肾小球滤过率的估算值低于对照组(P<0.01),而2组肌酐差异无统计学意义(P>0.05)。通过受试者工作特征曲线分析Cys C曲线下面积为0.954,敏感度和特异度分别为92.1%与72.0%;U-Alb曲线下面积为0.97,敏感度和特异度分别为90.5%与68.2%。结论:Cys C、U-Alb联合检测能对糖尿病早期肾损害的早期诊断、早期干预性治疗提供可靠的参考依据。

Objective：To evaluate the detection of serum cystatin C（Cys C） and the related indicators in diagnosis of early renal damage in diabetic mellitus patients. Methods：Fifty cases of type 2 diabetes patients and 30 normal subjects were studied;the latexenhanced turbidimetric immunoassay,enzyme and immune nephelometry were employed to test the levels of serum Cys C,urea,creatinine,glomerular filtration rate and Urinary albumin（U-Alb） using Beckman AU5400 and Beckman IMMAGE800;then the results were compared between the two groups. Results：The levels of serum Cys C,U-Alb and urea in patients with diabetes mellitus were significantly higher than those in control group（P〈0. 01）;however,the difference in the level of serum creatinine was not statistically significant（P〈0. 05）. The area under the receiver operating characteristic curve analysis was 0. 95 by Cys C curve,and the sensitivity and specificity were 92. 1% and 72. 0%,respectively;the area under receiver operating characteristic curve of U-Alb was 0. 97,and sensitivity and specificity were 90. 5% and 68. 2%,respectively. Conclusions：Combination detection of the levels of serum Cys C and U-Alb may provide reliable basis for early diagnosis and intervention of the patients with early diabetic nephropathy.