2型糖尿病患者慢性肾脏疾病损害指标的探讨

Discussion on the chronic kidney disease damage index for Type 2 diabetes mellitus patients

目的探讨2型糖尿病患者慢性肾脏疾病损害指标的诊断方法。方法选取2009年3月至2013年7月,本院内科住院的2型糖尿病患者和定点医疗的门诊2型糖尿病患者247例,按照是否合并慢性肾脏病,分成2型糖尿病慢性肾病组(CKD组)113例、2型糖尿病组(T2DM组)134例,选择同期在本院体检的健康人员100例作为对照组(NC组),均抽取血液样本,采用免疫散射比浊法测定血清胱抑素C(CYS-C)、β2微球蛋白(β_2-MG),速率法测定血清尿素氮(BUN),酶法测定血清肌酐(SCr),尿酸酶法测定血清尿酸(UA)。结果 CKD组CYS-C(2.58±1.64)mg/L明显高于T2DM组(0.98±0.25)mg/L和NC组(0.87±0.11)mg/L,差异有统计学意义(P<0.01);CKD组β2-MG、BUN、SCr及UA明显高于T2DM组,且均高于NC组,差异均有统计学意义(P<0.01)。结论 CYS-C在临床上可作为肾小球滤过率(GFR)的判断指标,有助于2型糖尿病慢性肾脏病损害的早期诊断。

Objective To explore diagnosis method of chronic kidney disease damage for patients with type 2 diabetes.Methods From March 2009 to July 2013, 247 cases of patients with type 2 diabetes came from hospitalized patients and outpatient patients, according to whether with chronic kidney disease, they were divided into type 2 diabetes nephropathy group （CKD group, n = 113）, type 2 diabetes mellitus group （T2DM group, n = 134）. During the them period, 100 cases visit our hospital for personnel physical examination were chose as control group （NC group）, all the objects were asked to collect blood samples, Serum Cystain C （CYS-C） and beta 2-microglobulin （[32 -MG ） were determined by immune scattering nephelometry, Blood urea nitrogen （BUN） was measured performance rate method, Enzymatic method is used to determine the serum creatinine （SCR）, Uric acid enzymatic was used to determine the serum Uric acid （UA）.Results Serum Cystain C in CKD group was 2.58± 1.64 mg/L, which was obviously higher than 0.98±0.25 mg/L in T2DM group and 0.87±0.11 mg/L in normal control group （P〈0.01）. At the same time, beta 2-microglobulin （beta 2-MG）, BUN,SCr and UA in CKD group were higher than those in T2DM group and NC group, and the differences were statistically significant （P〈0. 05 ）. Conclusions Cys-C can be used as a clinical indicator of glomerular filtration rate （ GFR）, which is helpful for the early diagnosis of chronic renal damage in type 2 diabetes mellitus.