HbA1C、MA和Cys-C联合检测在糖尿病肾病患者早期诊疗中的应用价值

Application value of combined detection of HbA1C,MA and Cys-C in early diagnosis and treatment of diabetic nephropathy patients

目的探讨糖化血红蛋白(Hb A1C)、尿微量白蛋白(MA)和胱抑素C(Cys-C)联合检测在糖尿病肾病(DN)患者早期诊疗中的应用价值。方法收集2016年1月~2017年10月来深圳市宝安区福永人民医院就诊的糖尿病(DM)患者273例,其中DN组患者95例,非DN组患者178例,同时选择同期健康体检人群120例为对照组,分别检测各组血中Hb A1C,MA,Cys-C,尿酸(UA)、肌酐(CR)和尿素氮(BUN),并分析各组检测结果是否存在差异性。结果 DN组患者血中Hb A1c,MA和Cys-C浓度分别为(12.76±3.19)%,(83.03±34.27)mg/L和(2.94±1.03)mg/L,明显高于非DN组,差异有统计学意义(t=4.196,5.084,6.025,P<0.05),UA,CR和BUN浓度分别为(512.53±142.74)μmol/L,(119.46±31.32)μmol/L和(6.80±3.01)mmol/L,略高于非DN组,但差异均无统计学意义(t=1.052,1.383,1.603,P>0.05)。DN组和非DN组患者血中以上各指标浓度均高于对照组,差异均有统计学意义(P<0.05);DM患者血中Hb A1C,MA和Cys-C水平随病程延长而呈逐步上升趋势,且不同病程之间差异均有统计学意义(P<0.05),DN患者治疗后血中Hb A1C,MA和Cys-C浓度分别为(6.27±2.06)%,(49.38±21.05)mg/L和(1.32±0.49)mg/L,明显低于治疗前,差异有统计学意义(P<0.05)。结论 DN患者血中Hb A1C、MA和Cys-C浓度明显高于非DN患者,且治疗后明显降低。因此,联合检测对DN早期诊断和疗效判断具有参考价值,值得推广应用。

Objective To explore the application value of combined detection of glycated hemoglobin（Hb A1 C）,urinary albumin（MA） and cystatin c（Cys-C） in the early diagnosis and treatment of diabetic nephropathy. Methods Two hundred and seventy-three cases of diabetes mellitus（DM） were collected from Fuyong People＇s Hospital of Baoan District from January 2016 to October 2017.Among them,there were 95 patients in dn group and 178 patients in non-dn group.At the same time,120 healthy people in the same period were selected as the control group to detect Hb Al C,ma,Cys-C,uric acid（ua）,creatinine（Cr） and urea nitrogen（bun） in the blood of each group respectively,and to analyze whether there were differences in the detection results of each group. Results The concentrations of Hb A1 C,MA and C ys-C in DN group were（12.76±3.19）%,（83.03±34.27）mg/L and（2.94±1.03）mg/L,respectively,which were significantly higher than those in non-DN group,the difference was statistically significant（t=4.196,5.084,6.025, P〈0.05）;The concentrations of UA,CR and BUN were（512.53±142.74）μmol/L,（119.46±31.32） μmol/L and（6.80±3.01） mmol/L,respectively,slightly higher than those in the non-DN group,but the difference was not statistically significant（t=1.0524,1.3829,1.6032,P〈0.05）.The concentrations of above indexes in blood of DN group and non-DN group were higher than those of control group,and the difference was statistically significant（P〈0.05）.The serum concentrations of Hb A1 C,MA and C ys-C in DN patients after treatment were（6.27±2.06）%,（49.38±21.05）mg/L and（1.32±0.49）mg/L,respectively,which were significantly lower than those before treatment（P〈0.05）. Conclusion The concentrations of Hb A1 C,MA and Cys-C in DN patients were significantly higher than those in non DN patients,and decreased significantly after treatment.Therefore, combined detection has reference value for early diagnosis and curative effect judgement of DN,and is worthy of popularization and application.