血清胱抑素C、糖化血红蛋白及尿微量白蛋白联合检测在2型糖尿病早期肾损伤中的临床价值

CLINICAL VALUE OF COMBINED DETECTION OF CYSC,HBAIC AND UMALB IN EARLY RENAL INJURY IN TYPE 2 DIABETE MELLITUS

目的:探讨联合检测血清胱抑素C(CysC)、糖化血红蛋白(HbAlc)及尿微量白蛋白(UmALB)在诊断2型糖尿病早期肾损伤中的临床价值。方法:选择2017-01~2017-06在我院就诊的2型糖尿病病人180例,其中单纯糖尿病病人60例(B组)、早期肾损伤病人60例(C组)、糖尿病肾病病人60例(D组),另选择同期在我院体检健康者60例(A组),检测4组的CysC、HbAlc及UmALB水平,并比较C组病人3项指标单独检测、联合检测的阳性率及ROC曲线下面积。结果:检测结果表明C、D组病人的CysC、HbAlc、UmALB水平均高于A、B组(P<0.05),且D组各项指标明显高于C组(P<0.05);B组病人与A组比较UmALB无明显差异(P>0.05),而CysC、HbAlc差异明显(P<0.05);3项指标联合检测的阳性率为96.67%,均明显高于CysC的78.33%、HbAlc的76.67%和UmALB的85.00%(P<0.05);联合检测的ROC曲线下面积为0.912,大于CysC、HbAlc、UmALB各指标的ROC曲线下面积。结论:CysC、HbAlc、UmALB的水平变化均与糖尿病肾损伤有关,3项指标联合检测可提高阳性检出率,为病人病情严重程度的诊断和治疗提供参考。

Objective:To evaluate the clinical value of combined detection of CysC,HbAlc and UmALB in the diagnosis of early renal injury in type 2 diabetes mellitus.Methods:180 patients with type 2 diabetes mellitus were selected from January 2017 to June-2017 in our hospital,including 60 patients with diabetes(group B),patients with early renal injury in 60 cases(C group),60 cases with diabetic nephropathy(D group),selected in our hospital 60 cases of healthy subjects(A group),4 groups were detected CysC,HbAlc and UmALB level,and compared the positive rate of C group were 3 indicators of separate and combined detection.Results:The results showed that the C group and D group Cys C,HbAlc,UmALB higher than those in A group and B group(P<0.05),and the indexes of group D was significantly higher than that of C group(P<0.05);there was no significant difference in UmALB between group B and group A patients(P>0.05),Cys C,HbAlc difference obviously(P<0.05);the positive rate of combined detection of 3 indexes of 96.67%were significantly higher than that in Cys C 78.33%,HbAlc 76.67%,UmALB 85%(P<0.05).The area under the ROC curve of joint detection was 0.912,greater than the area under the ROC curve of Cys,C,HbAlc and UmALB.Conclusion:The changes of Cys,HbAlc and UmALB levels are related to the renal injury in diabetes mellitus,and the combined detection of the 3 indexes can improve the positive detection rate and provide a reference for the diagnosis and treatment of the disease severity of the patients with C.