Cysc、mAlb/Cr及Ⅳ-C检测在2型糖尿病肾病诊断中的价值

Value of Cysc,mAlb/Cr and Ⅳ-C detection in the diagnosis of type 2 diabetic nephropathy

目的探讨血清胱抑素(Cysc)、尿微量蛋白/肌酐(m Alb/Cr)及Ⅳ型胶原(Ⅳ-C)指标在早期诊断2型糖尿病肾病中的价值。方法选取2016年1月~2017年1月在我院接受治疗的60例2型糖尿病患者作为研究对象,按照尿蛋白的不同分为观察A组(微量蛋白尿)与观察B组(大量蛋白尿),各30例。同时另在门诊体检健康者中随机选取30例作为对照组。应用增强比浊法测定血清Cysc值,采用免疫散射法测定尿m Alb值,采用碱性苦味酸法测定尿Cr,采用ELISA法测定Ⅳ-C值。记录单独检测及联合检测Cysc、m Alb/Cr及Ⅳ-C值的检出率,比较单独检测及联合检测Cysc、m Alb/Cr及Ⅳ-C的敏感度、特异度、假阳性率、假阴性率。结果观察A组和观察B组的Cysc、m Alb/Cr及Ⅳ-C指标相较于对照组显著升高,且观察B组Cysc、m Alb/Cr及Ⅳ-C指标相较于观察A组显著升高(P<0.05);联合测定指标相较于单独测定的敏感度、特异度显著提高(P<0.05);联合测定指标相较于单独测定的假阳性率及假阴性率显著降低(P<0.05)。结论临床上应用Cysc、m Alb/Cr及Ⅳ-C指标早期诊断2型糖尿病肾病的效果较单独测定该三项指标显著改善,准确度和特异度均较高,具有临床应用和推广意义。

Objective To investigate the value of the serum cystatin （Cysc）,urinary albumin/creatinine （mAlb/Cr） and type 1V collagen （Ⅳ-C） in the early diagnosis of type 2 diabetic nephropathy.Methods From January 2016 to January 2017,60 patients with type 2 diabetes mellitus in our hospital were selected and divided into the observation group A （microalbuminuria） and the observation group B （large proteinuria） according to the different urine protein,30 cases in each group.At the same time,30 healthy volunteers in outpatient department of our hospital were randomly selected as the control group.The level of serum Cysc was determined by enhanced turbidimetry,the mAlb value of urine was determined by immune scattering method,the urinary Cr was determined by alkaline picric acid method,the Ⅳ-C value was determined by ELISA method.The detection rates of Cysc,mAlb/Cr and Ⅳ-C of combined determination and single determination were recorded,The sensitivity,specificity,false positive rate and false negative rate of Cysc,mAlb/Cr and Ⅳ-C of combined determination and single determination were compared.Results The level of Cysc,mAlb/Cr and Ⅳ-C of the observation group A and group B increased significantly compared with the control group,while the level of Cysc,mAlb/Cr and Ⅳ-C of the observation group B increased significantly compared with the observation group A （P〈 0.05）.Combined with the single determination,the sensitivity and specificity in the combined determination significantly increased （P〈0.05）.Compared with the single index measurement,the false positive rate and the false negative rate of combined determination was significantly lower （P〈0.05）.Conclusion Compared with the single determination of the three indicators,the clinical application of combined determination of Cysc,mAlb/Cr and Ⅳ-C index in the early diagnosis of type 2 diabetic nephropathy were significantly improved,and the accuracy and specificity were higher,with dinical application and promotion significance.