2型糖尿病肾病患者治疗前后血清胱抑素 C和β2微球蛋白变化的临床意义研究

Clinical significance of the changes of serum Cystatin C andβ2 microglobulin before and after the treatment of type 2 diabetic nephropathy

目的：研究2型糖尿病肾病患者治疗前后血清胱抑素C（ Cys C）和β2微球蛋白（β2－MG）变化的临床意义。方法选取河南大学淮河医院86例2型糖尿病患者为研究对象，根据尿白蛋白排泄率（UAER）分为A、B两组，A组（n＝45）为早期糖尿病肾病组，B组（n＝41）为无肾病糖尿病组，两组均采取糖尿病常规治疗，A组在常规治疗基础上加用厄贝沙坦治疗，另选同期健康体检者40例为C组，比较三组Cys C、β2－MG、空腹血糖、糖化血红蛋白（HbA1c）、同型半胱氨酸（Hcy）、血尿酸（UA）、尿素氮（BUN）、肌酐（Scr）变化情况。结果治疗前A组各指标显著高于B、C组，经治疗后A、B组各指标水平显著下降（P＜0.05），与B组治疗后比较差异未见统计学意义（P＞0.05），治疗后A、B两组与C组各指标水平比较仍显著较高（P＜0.05）。结论经厄贝沙坦及常规治疗后，2型糖尿病肾病患者Cys C与β2－MG水平显著降低，表示两者均可作为疗效判定的观察指标。

Objective To study the clinical significance of the changes of cystatin C （Cys C） andβ2 microglobulin （β2-MG） before and after the treatment of type 2 diabetic nephropathy .Methods Eighty-six cases of type 2 diabetic in Huaihe hospital affiliated to Henan university were selected as the research objects.According to the UAER, they were divided into group A and group B .Group A（n=45）was early diabetic nephropathy group and group B （ n=41） was no nephropathy diabetic group .The two groups all a-dopted routine treatment of diabetic .On the basis treatment , group A received irbesartan and another 40 cases of healthy people in the same period were chosen as group C .The changes of Cys C ,β2-MG, fasting blood glucose , HbA1c, Hcy, UA, BUN and Scr were compared among the three groups .Results Before the treatment , all indexes of group A were significantly higher than those of group B and group C .After treatment , the levels of group A and group B decreased significantly （ P〈0.05） and showed no significant difference compared with group B （P〉0.05）.However, compared with group C, the levels of group A and group B were still significantly higher （P〈0.05）.Conclusions After treatment of irbesartan and conventional treatment , the levels of Cys C andβ2-MG in patients with type 2 diabetic nephropathy decrease significantly,so the levels of Cys C and β2-MG can be regarded as observation index to value the curative effect .