血清胱抑素C和尿微量白蛋白的联合检测对糖尿病肾病早期诊断的临床评价

Clinical Evaluation of Combined Determination of Serum Cystatin C and Urinary Microalbumin in the Early Diagnosis of Diabetic Nephropathy

目的探讨血清胱抑素C和尿微量白蛋白联合检测在糖尿病肾病早期肾损伤中的诊断价值。方法选取2016年1月至2017年3月来院诊治的糖尿病患者58例,根据ECT检测肾小球滤过率(GFR)将患者分为三组:分别为肾功能中度及以上损伤组(GFR<60 m L/min)15例,肾功能轻度损伤组(GFR 60~90 m L/min)30例,肾功能正常组(GFR≥90 m L/min)13例,正常对照组为本院体检中心同期健康体检者30名。检测各组胱抑素C、尿微量白蛋白、肌酐、尿素氮的浓度水平。结果糖尿病肾功能中度及以上损伤组、肾功能轻度损伤组、肾功能正常组和正常对照组的血清胱抑素C和尿微量白蛋白结果比较,差异有显著性统计学意义(P<0.01);糖尿病肾功能中度以上损伤组、轻度损伤组分别和肾功能正常组、正常对照组间的Scr和BUN水平差异也有显著性统计学意义(P<0.01),而第三组和正常对照组Scr和BUN的浓度水平差异无统计学意义(P>0.05)。血清胱抑素C和尿微量白蛋白的联合检测检测糖尿病肾病的阳性率(84.4%)明显高于Scr(42.2%)和BUN(44.4%)。结论胱抑素C检测对糖尿病肾病的早期诊断具有较高的应用价值,而胱抑素C和尿微量白蛋白联合检测可以明显提高对糖尿病肾病的早期诊断的检出率。

Objective To investigate the diagnostic value of serum cystatin C combined with urinary microalbumin in early renal injury of diabetic nephropathy. Methods To select 58 cases of diabetes diagnosed in our hospital from January 2016 to March 2017. Patients were divided into three groups according to the ECT test for glomerular filtration rate（GFR）： 15 cases with moderate renal function damage and above injury group; 30 cases with mild renal impairment; and 13 cases of normal renal function group. 30 cases healthy examinees in the physical examination center of our hospital as normal control group. The levels of cystatin C,urinary microalbumin, creatinine and urea in each group were analyzed. Results Comparison of serum Cys C and urine m ALB results in patients with diabetes mellitus with moderate or high renal function impairment,mild renal impairment, normal renal function group and normal control group, the difference was statistically significant（P〈0.01）; The levels of serum Scr and BUN from diabetes mellitus with moderate and higher renal function impairment, mild renal function impairment group were higher than those in the normal renal function group and the normal control group, the difference was statistically significant（P〈0.01）. The concentration of Scr and BUN in the third groups had no statistical significance compared with the normal control group（P〉0.05）. The positive rate of serum cystatin C and urinary microalbumin in diabetic nephropathy（84.4%） was significantly higher than that in creatinine（42.2%） and urea（44.4%）. Conclusion Serum cystatin C detection has a higher value in early diagnosis of diabetic nephropathy. The combined detection of cystatin C and microalbuminuria can significantly improve the detection rate of early diagnosis of diabetic nephropathy.