六种生化指标在糖尿病性肾病早期诊断中的临床应用价值

Six Kinds of Biochemical Indexes in the Clinical Application Value for Early Diagnosis of Diabetic Nephropathy

目的探讨血清胱抑素C（Cys C）、游离脂肪酸（FFA）、同型半胱胺酸（Hcy）、血尿酸（SUA）、β2微球蛋白（β2-MG）和C反应蛋白（CRP）在糖尿病性肾病（DN）早期诊断中的临床应用。方法选择2012年1月~2014年10月住院的2型糖尿病患者260例,其中：1单纯糖尿病组（SDM组）105例;2早期糖尿病肾病组（EDN组）85例;3临床糖尿病肾病组（CDN组）70例,并以50例健康体检者作为对照者组。采用日立全自动生化分析仪7600-010型检测Cys C、FFA、Hcy、SUA、β2-MG和CRP含量。结果 1糖尿病组与正常对照组比较：Cys C、FFA、Hcy、UA、β2-MG和CRP水平显著升高,差异有明显显著变化（P〈0.05）,具有统计学意义。2各组相互比较：对照组、SDM组、EDN组和CDN组的Cys C、FFA、Hcy、SUA、β2-MG和CRP水平呈趋势性升高,差异有明显显著变化（P〈0.05）,具有统计学意义。结论血Cys C、FFA、Hcy、SUA、β2-MG和CRP水平与糖尿病肾病有密切关系,可作为糖尿病患者早期肾脏损伤的敏感指标,若将这六种指标作为糖尿病患者的常规检查,对糖尿病患者的肾损伤预测及防治具有重要的临床参考应用价值,可以大大提高糖尿病患者的生存质量。

Objective Study of serum cystatin C（ Cys C）,Free Fatty Acids（ FFA）,homocysteine（ Hcy）,blood uric acid（ SUA）,β2- microglobulin（ β2- MG） and C reactive protein（ CRP） in diabetic nephropathy（ DN） in the early diagnosis of clinical application. Methods 2012 January to 2014 October to choose between 260 type 2 diabetespatients in our hospital department of endocrinology in hospital patients,including the simple diabetic group（ SDM group） 105 cases; the earlydiabetic nephropathy group（ EDN group） 85 cases; clinical diabetic nephropathy group（ CDN group） 70 cases,and 50 cases of healthysubjects as a control group. Using Hitachi automatic biochemical analyzertype 7600- 010 detection of Cys C,FFA,Hcy,SUA,β2- MG and CRP content. Results The diabetic group compared with the normal control group： Cys C,FFA,Hcy,UA、β2- MG and CRP levels significantly increased,the difference is obviously significant change（ P〈0. 05）,with statistical significance. In each group,compared with each other： control group,SDM group,EDN group and CDN group of Cys C,FFA,Hcy,UA,β2- MG and CRP levels of beta showed a trend of increase,the difference obviously significant change（ P〈0. 05）,with statistical significance. Conclusions Blood Cys C,FFA,Hcy,SUA,β2- MG and CRP levels have close relationship with diabetic nephropathy,and can be used as a sensitive indicator of diabetic patients with early renal damage,if the six indicators as the routine examination of diabetic patients,the prediction and prevention of kidney injury in patients with diabetes has important clinical reference value,can significantly improve the quality of life of diabetic patients.