探讨同型半胱氨酸检测对糖尿病肾病的应用价值

Study on application value of homocysteine determination in diagnosis of diabetic nephropathy

目的探讨同型半胱氨酸的检测对糖尿病肾病早期诊断的临床应用价值。方法选取2013年1月至2014年6月在重庆市丰都县中医院门诊和住院治疗并确诊为糖尿病肾病的患者120例纳入试验组,根据病程长短分为Ⅰ期组(32例)、Ⅱ期组(28例)、Ⅲ期组(30例)、Ⅳ期组(30例)。另选取同期体检健康者30例纳入对照组。所有研究对象均进行同型半胱氨酸和胱抑素C的检测并综合分析结果。结果不同病程试验组患者血清同型半胱氨酸和胱抑素C水平均高于对照组,差异均有统计学意义(P<0.05),且随着病程的延长其血清中的水平均呈现逐步上升的趋势;同一病程试验组患者血清同型半胱氨酸和胱抑素C的阳性率比较,差异均无统计学意义(P>0.05),且均在80.00%以上。结论同型半胱氨酸是一种早期诊断糖尿病肾病的有效指标,具有较高的灵敏度,对于该疾病的诊断、监测和预后都具有一定的参考价值。

Objective To explore the clinical application value of homocysteine（Hcy）determination in early diagnosis of diabetic nephropathy.Methods A total of 120 patients confirmed with the diabetic nephropathy treated in the outpatient and inpatient departments of our hospital from Jan.2013 to Jun.2014 were enrolled as the experiment group.All cases were divided into the four groups according to the course of disease,including the period Ⅰgroup（n=32）,period Ⅱ group（n=28）,period Ⅲ group（n=30）and period Ⅳ group（n=30）.Other contemporaneous 30 healthy people of physical examination were selected as the control group.Hcy and Cys-C were detected in the experiment groups and control group,and the detection results were analyzed comprehensively.Results The serum Hcy and Cys-C levels in different disease courses of the experimental group were significantly higher than those in the control group,the differences were statistically significant（P〈0.05）,moreover the levels were gradually increased with the extending of the disease course.The positive rate of serum Hcy and Cys-C in the same disease course of experiment group had no statistically significant differences（P〉0.05）.Conclusion Hcy could be an effective indicator with high sensitivity for the early diagnosis of diabetic nephropathy,and could have certain reference value for the diagnosis,monitoring and prognosis of diabetic nephropathy.