血浆NGAL和血清CysC在糖尿病肾病早期诊断中的临床价值

Clinical value of plasma NGAL and serum CysC in early diagnosis of diabetic nephropathy

目的探讨2型糖尿病(T2DM)患者血浆中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和血清胱抑素C(CysC)的改变及其对糖尿病肾病(DN)的诊断价值。方法选择T2DM患者58例,根据尿微量清蛋白/尿肌酐比值(ACR)分为正常清蛋白尿组(ACR<30mg/mmol)和高清蛋白尿组(ACR≥30mg/mmol);另选择40例健康体检者作为对照,测定其血浆NGAL、血清CysC、肾功能、血糖及血脂等水平。结果血浆NGAL和血清CysC水平在对照组、正常清蛋白尿组和高清蛋白尿组中呈逐步增高趋势,差异有统计学意义(P<0.05);Pearson相关分析,血浆NGAL与血清CysC、肌酐(CREA)呈正相关(相关系数分别为0.58、0.43、0.66,P<0.05);血清CysC与CREA、BUN亦呈正相关(相关系数分别为0.73、0.58,P<0.05)。结论 DN患者血浆NGAL与血清CysC水平显著升高,二者呈明显正相关,均与肾损伤程度有关,二者可以作为DN早期无创性诊断指标。

Objective To explore the changes and diagnostic value of plasma neutrophil gelatinase associated lipocalin （NGAL） and serum cystatin C （CysC） in diabetic nepbropathy （DN）. Methods 58 patients with type 2 diabetes meIlitus（T2DM） were di vided into 2 groups according to urinary microalbumin to creatinine ratio （ACR） .. normal albumin urine group （ACRe30 mg / retool） and high albumin urine group（ACRe30 mg/mmol）. At the same time,40 individuals undergoing healthy physical examina tion were selected as the control group. The levels of plasma NGAL,serum CysC,renal function and glucose were detected. The re- sults were statistically processed. Results Plasma NGAL and serum CysC levels in the control group,normal albumin urine group and high albumin urine group showed the gradually increasing trend, the differences were statistically significant （P〈0.05）. The Pearson correlation analysis：plasma NGAI. level was positively correlated with serum CysC,creatinine（GREA）,and blood usea ni trogen（BUN） （correlation coefficients 0.58,0.43,0.66 respectively, P〈0.05） ;serum CysC was also positively correlated with serum CREA and BUN （correlation coefficients 0.73,0.58 respectively,P〈0.05）. Conclusion Plasma NGAL and serum CysC levels in DN patients are significantly increased,both show a significantly positive correlation and are related with renal injury degree. Their combined detection could serve as a noninvasive diagnostic indicator for early diagnosis of DN.