血清胱抑素C、尿微量白蛋白/肌酐比值联合测定在老年2型糖尿病早期肾病诊断的价值

Diagnostic Value of Measuring Serum Cystatin C and Microalbuminuria/Creatinine Simultaneously in Elderly Type 2 Diabetic Nephropathy

目的:探讨血清胱抑素C(Cys-C)、尿微量白蛋白(UAlb)/肌酐(Cr)水平的联合测定对老年2型糖尿病肾病(DN)的诊断价值。方法:入选老年2型糖尿病(T2DM)患者120例,根据内生肌酐清除率(Ccr)分三组:肾功能正常组,Ccr≥90 m L/min,40例;肾功能轻度减退组,60 m L/min≤Ccr<90 m L/min,40例;肾功能重度减退组,Ccr<60 m L/min,40例。并以40例健康体检者作为对照组,四组年龄均≥60岁。用免疫比浊法测定各组Cys-C、UAlb/Cr比值。结果:肾功能轻度减退组和肾功能重度减退组患者Cys-C及UAlb/Cr水平与肾功能正常组及对照组比较明显升高,且差异具有统计学意义(P<0.05)。肾功能轻度减退组Cys-C、UAlb/Cr水平明显低于肾功能重度减退组,比较差异有统计学意义(P<0.05);且Cys-C及UAlb/Cr比值水平,均与血Cr水平成正相关。结论:联合测定Cys-C及UAlb/Cr比值对老年2型糖尿病患者早期肾功能损伤评价,具有十分重要价值,有利于早期干预及治疗。

Objective： To study the value of measuring serum cystatin C and microalbuminuria/creatinine simultaneously in the early diagnosis of elderly type 2 diabetic nephropathy. Method： 120 selected elderly T2 DM patients were divided into 3 groups according to their endogenous creatinine clearance rate： normal renal function group, Ccr ≥ 90 m L/min, 40 cases; mild decline in renal function group, 60 m L/min ≤ Ccr90 m L/min, 40 cases; severe decline in renal function group, Ccr60 m L/min, 40 cases; another 40 elderly healthy persons were enrolled in control group. Cys-C and UAlb/Cr were measured by immune turbidimetric test. Result： Cys-C and UAlb/Cr in mild decline in renal function group and severe decline in renal function group were significantly higher than that of normal renal function group and control group, and the differences of that in normal renal function group were significantly lower than that in mild decline in renal function group. Meanwhile Cys-C and UAlb/Cr were positively correlated with serum creatinine. Conclusion： Combined determination of Cys-C and UAlb/Cr ratio is beneficial to early evaluation, intervention and treatment for elderly type 2 diabetic patients with early renal damage.