尿足细胞联合Cys-C、hs-CRP、Cr、FA及Hcy检测对DN早期诊断的意义

The significance of urinary podocyte combined with levels of Cys-C, hs-CRP,Cr, FA and Hcy in the early diagnosis of DN

目的探讨尿足细胞、胱抑素C(Cys-C)、超敏C反应蛋白(hs-CRP)、血清肌酐(Cr)、脂肪酸(FA)、同型半胱氨酸(Hcy)等指标水平对糖尿病肾病(DN)早期诊断的价值。方法选择2016年1月至2017年6月本院收治的2型糖尿病肾病或者单纯2型糖尿病(T2DM)患者154例,根据24 h尿微量白蛋白排泄率(UAER)分为T2DM组(55例)、早期DN组(57例)和DN组(42例),选择同期进行健康体检者45人作为对照组。检测各组血清Cys-C、hsCRP、Cr、FA、Hcy、UAER及尿足细胞个数。采用方差分析和应用Pearson相关性分析对各指标进行统计学分析。结果 DN组患者血清中Cys-C、hs-CRP、Cr、FA、Hcy及尿足细胞水平均显著高于其他各组(P<0.05);早期DN组患者血清中Cys-C、hs-CRP、FA、Hcy及尿足细胞水平均显著高于T2DM组和对照组(P<0.05);T2DM组患者血清中Cys-C、hs-CRP、FA、Hcy及尿足细胞水平均显著高于对照组(P<0.05);T2DM患者Cys-C、hs-CRP、Cr、FA、Hcy及尿足细胞水平均与UAER呈正相关(r=0.718、0.534、0.417、0.403、0.361、0.311,P<0.05)。结论糖尿病患者Cys-C、hsCRP、Cr、FA、Hcy及尿足细胞水平与糖尿病肾病的发展进程有关,各项指标的联合检测对糖尿病肾病的早期诊断有重要的临床应用价值。

Objective To investigate the relationship between indexes of urinary podocyte,cystatin C（Cys-C）,high-sensitivity C-reactive protein（hs-CRP）,serum creatinine（Cr）,fatty acids（FA）,homocysteine（Hcy）levels with type 2 diabetes mellitus（T2 DM）at different stages,and determine their application values. Methods 154 cases of patients with type-2 diabetic nephropathy（T2 DM）or diabetic nephropathy（DN）in our hospital from January 2016 to June 2017 were selected and divided into three groups according to the levels of urinary albumin excretion rates（UAER）：T2 DM group（n=55）,early DN group（n=57）and DN group（n=42）. 45 healthy subjects of the same period determined by physical examination were enrolled as the control group. Urinary podocyte,Cys-C,hs-CRP,Cr,FA,Hcy levels were determined. T test and variance analysis and Pearson correlation analysis were applied for the statistical analysis of all indexes. Results The levels of Cys-C,hs-CRP,Cr,FA,Hcy and urinary podocyte in DN group were significantly higher than those of other groups（P〈0.05）;the levels of Cys-C,hs-CRP,FA,Hcy and urinary podocyte in early DN group were significantly higher than those in T2 DM group and control group（P〈0.05）;the levels of Cys-C,hs-CRP,FA,Hcy and urinary podocyte in early T2 DM group were significantly higher than those of control group（P〈0.05）. In T2 DM patients,the Cys-C,hs-CRP,FA,Hcy and urinary podocyte levels were found positively correlated with UAER（r=0.718,0.534,0.417,0.403,0.361,0.311,P〈0.05）. Conclusion The levels of Cys-C,hs-CRP,Cr,FA,Hcy and urinary podocyte in T2 DM patients are related with the development process of diabetic nephropathy. Joint detection of all indexes has significant clinical application value in the early diagnosis of diabetic nephropathy.