血清胱抑素C在糖尿病肾病患者早期诊断中的价值

Value of serum cystatin C in early diagnosis for diabetic nephropathy

目的分析血清胱抑素C(CysC)在糖尿病肾病患者早期诊断中的临床价值。方法选择2013年3月至2014年3月该院诊治的98例糖尿病患者,按尿清蛋白排泄率(UAER)分为单纯糖尿病组49例,糖尿病肾病组49例,另选取同期健康体检者49例纳入对照组,比较3组受试者CysC、β2-微球蛋白(β2-MG)、尿素氮(BUN)、血肌酐(Scr)、尿微量清蛋白(mAlb)、糖化血红蛋白(HbAlc)等生化指标水平。结果对照组HbAlc、mAlb水平均明显低于其他2组,单纯糖尿病组均低于糖尿病肾病组,差异均有统计学意义(P<0.05);对照组HbAlc、mAlb水平均明显低于其他2组,单纯糖尿病组均明显低于糖尿病肾病组,差异均有统计学意义(P<0.05);糖尿病肾病组患者CysC、β2-MG阳性率明显高于其他2组,且分别明显高于BUN、Scr指标阳性率,差异均有统计学意义(P<0.05);单纯糖尿病组CysC、β2-MG阳性率明显高于BUN、Scr指标阳性率,差异均有统计学意义(P<0.05)。结论 CysC在糖尿病肾病患者早期诊断中的临床价值较高,提示患者的糖尿病发展情况,可作为临床诊断的主要依据指导相关治疗方案。

Objective To analyze the value of serum cystatin C （CysC） for early diagnosis for diabetic nephropathy .Methods A total of 98 patients with diabetes nephropathy from March 2013 to March 2014 were enrolled in this study .According to the level of urinary albumin excretion rate （UAER） ,the patients were divided into simple diabetic group（49 patients） and early diabetic ne‐phropathy group（49 patients） .Other 49 healthy subjects were recruited as the control group .The levels of CysC ,β2‐microglobulin （β2‐MG） ,urea nitrogen（BUN） ,serum creatinine（Scr）、urine microalbumin（mAlb） ,glycosylated hemoglobin（HbAlc）were analyzed in the three groups .Results The levels of HbAlc ,mAlb in the control group were significant lower than those of the other two groups ,and those in the simple diabetic group were significant lower than those of the early diabetic nephropathy group ,the differ‐ences were statistical significant（P〈0 .05）;The positive rates of CysC andβ2‐MG in the early diabetic nephropathy group were sig‐nificant higher than those in the other two groups ,and significant higher than those of BUN ,Scr indicators respectively ,those in the simple diabetic group were significant lower than those of the early diabetic nephropathy group ,the differences were statistical sig‐nificant（P〈0 .05） .Conclusion CysC has important clinical value in the early diagnosis of patients with diabetic nephropathy ,could indicate the development of diabetic patients ,and could be used as the main basis for the clinical diagnosis of guidance related to treatment .