血清胱抑素C检测在2型糖尿病肾病早期诊断中的临床价值

Clinical value of detection and evaluation of serum cystatin C in early diagnosis of diabetic nephropathy for type 2 diabetes mellitus

目的 评估血清胱抑素C检测水平在2型糖尿病肾病早期诊断中的临床价值,为2型糖尿病肾病的早期诊断提供临床诊断依据。方法 选取2014年10月-2015年6月于我院就诊的2型糖尿病患者162例,按24 h尿微量白蛋白（m Alb）分为3组：正常白蛋白尿组（m Alb〈30 mg/24 h）68例,微量白蛋白尿组（m Alb 30-300 mg/24 h）52例和临床白蛋白尿组（m Alb〉300 mg/24 h）42例,并在健康体检中心随机选取健康对照（正常对照组）80例。测定全部受检人群的血清胱抑素C水平,同时测定血尿素氮、血肌酐和尿m Alb水平,并对检测结果进行统计分析。结果 在所有受检人群中,正常对照组的血清胱抑素C、尿m Alb水平最低,临床白蛋白尿组最高。其他3组与正常对照组的血清胱抑素C、尿m Alb水平差异均有统计学意义（P〈0.05）,除正常对照组外,其他3组的血清胱抑素C、尿m Alb水平组间比较差异有统计学意义（P〈0.05）。微量蛋白尿组与临床蛋白尿组的血清胱抑素C水平与尿m Alb水平呈显著正相关（r分别为0.107、0.152,P〈0.05）。结论 血清胱抑素C水平与2型糖尿病患者的早期肾损伤程度密切相关,在糖尿病肾病的早期诊断中具有临床价值。

Objective To estimate the clinical value of serum cystatin C（ Cys C） detection level in early diagnosis of diabetic nephropathy for type 2 diabetes mellitus and to provide clinical diagnosis basis for early diagnosis of diabetic nephropathy for type 2 diabetes mellitus. Methods 162 patients with type 2 diabetes mellitus from October 2014 to June 2015 received by our hospital were selected and they were divided into 3 groups according to urinary microalbumin（m Alb）,namely normal albuminuria group（m Alb30 mg/24 h,n =68）,microalbuminuria group（m Alb 30 -300 mg/24 h,n=52） and clinical proteinuria group（m Alb300 mg/24 h,n=42）.And healthy control 80 cases（normal control group）were selected randomly in healthy check-up center.The level of serum Cys C of all examinees was determined,and the level of blood urea nitrogen（BUN）,serum creatinine（SCr） and urinary microalbumin（m Alb） was determined respectively and simultaneously.The test results were counted and analyzed. Results The level of Cys C and m Alb were the lowest in normal control group and clinical proteinuria group was the highest in all examinees.There was a statistical difference of level of serum Cys C and urinary m Alb between the other 3 groups and normal control group（P〈0.05）.In addition to normal control group,there was a statistical difference of the level of Cys C and urinary m Alb among the other three groups（P〈0.05）. There was a significant positive correlation between the level of Cys C and urinary m Alb level in microalbuminuria group and clinical proteinuria group of（r=0.107,0.152,P〈0.05）. Conclusion The level of Cys C is closely related to the degree of early renal damage in patients with type 2 diabetes mellitus,and it has clinical value in early diagnosis of diabetic nephropathy.