血清CysC与血β2-MG对糖尿病肾病患者的诊断价值

Diagnostic value of serum CysC and blood β2-MG in patients with diabetic nephropathy

目的探讨血清胱抑素C(CysC)与血β2-微球蛋白(β2-MG)对糖尿病肾病(DN)患者的诊断价值。方法选取2012年1月至2017年1月间在本院接受治疗的糖尿病(DM)患者80例,依据患者尿白蛋白排泄率将其分成三组:单纯DM组(30例),早期DN组(27例)和临床DN组(23例),选取同期在本院体检健康者30例作为对照组;对比四组对象血清内尿素氮(BUN)、CysC、血肌酐(SCr)和β2-MG含量以及BUN、CysC、SCr和β2-MG的阳性人数并计算其阳性率,对早期DN组患者血清CysC和β2-MG和临床相关指标进行相关性分析。结果单纯DM组和对照组BUN、CysC、SCr和β2-MG含量比较差异均无统计学意义(P>0.05);早期DN组患者Cysc和β2-MG含量高于单纯DM组及对照组,差异有统计学意义(P<0.05);临床DN组患者BUN、CysC、SCr和β2-MG含量明显高于其他三组,差异均有统计学意义(P<0.05);伴随着患者体内微量白蛋白增多,四组对象BUN、CysC、SCr和β2-MG阳性率逐渐增大,其中早期DN组患者CysC和β2-MG阳性率均高于50%,比SCr和BUN阳性率要高;早期DN组患者血清CysC和HbAlc、病程、尿Malb、SBP、BUN、血清β2-MG及血清Scr呈正相关关系;血清β2-MG和Hb Alc、病程、尿Malb、SBP、BUN、血清CysC及血清Scr呈正相关关系。结论 DN前期患者血清内β2-MG及CysC明显上升,比BUN和Scr更可靠、敏感,值得临床关注。

Objective To analyze the value of diagnosis and treatment of diabetic nephropathy （DN） with serum cystatin C （CysC） and blood β2-microglobulin （β2-MG）. Methods From January 2012 to January 2017 in our hospital, 80 cases of diabetes mellitus （ DM ） patients, according to urinary albumin excretion rate were divided into three groups ： DM group （ 30 cases ） , early DN group （27 cases） and clinical DN group （23 cases） ; 30 healthy people were selected as control. The serum levels of blood urea nitrogen （BUN） , CysC, serum creatinine （SCr） and 132-MG in the four groups were compared, and calculated for their positive rates. The CysC and β2-MG levels of the early DN group were analyzed. Results The contents of BUN, CysC, SCr and β2-MG in DM group and control group had no siguificantly difference （P〉0.05）. The contents of CysC and β2-MG in early DN group were higher than those in DM group and control group （P〈0.05）. The contents of BUN, CysC, SCr and 132-MG in patients with clinical DN were significantly higher than those in the other three groups （P〈0.05）. The positive rates of BUN, CysC, SCr and β2-MG were increased gradually, and the positive rates of CysC and β2-MG in early DN group were higher than 50%, which was higher than that of SCr and BUN. Serum levels of CysC and HbAlc, duration of disease, urinary Malb, SBP, BUN, serum β2-MG and serum Set in patients with early DN were positively correlated. Serum β2-MG and HbAlc, duration of disease, urine Malb, SBP, BUN, serum CysC and serum Scr were positively correlated. Conclusion Serum β2-MG and CysC in patients with early DN were significantly increased, more reliable than BUN and Scr, worthy of clinical attention.