CysC和Um Alb/Ucr及β2-MG在糖尿病肾病早期诊断中的应用价值

The application value of CysC,UmA lb/Ucr and β2 MG in early diagnosis of diabetic nephropathy

目的探讨血清胱抑素C(Cys C)、尿微量白蛋白/尿肌酐(Um Alb/Ucr)及β2微球蛋白(β2-MG)在2型糖尿病肾病(T2DN)早期诊断中的应用价值。方法选取2015年2月至2017年2月收治的T2DM患者142例为研究对象,根据尿微量白蛋白排泄率(UAER)水平患者分为观察组A(单纯T2DM) 62例、观察组B(早期T2DN) 47例及观察组C(T2DN) 33例,另选同期体检健康者40例为对照组。比较4组研究对象Cysc、Um Alb、Ucr及β2-MG值,分析三指标单项及联合应用检测T2DN的准确性。结果观察组A、观察组B与观察组C的Cys C、Um Alb/Ucr及β2-MG水平均显著高于对照组,观察组B与观察组C的Cys C、Um Alb/Ucr及β2-MG水平均显著高于观察组A,观察组C Cys C、Um Alb/Ucr及β2-MG水平均显著高于观察组B,差异有统计学意义(P <0. 05);对照组、观察组A、观察组B及观察组C的单项及联合检测检出率逐步升高,差异有统计学意义(P <0. 05);三项指标联合检测检出率均显著高于Cys C、Um Alb/Ucr及β2-MG单项检测,差异有统计学意义(P <0. 05); Cys C、Um Alb/Ucr及β2-MG联合检测敏感性94. 62%、特异性97. 15%及诊断符合率95. 78%分别显著高于单项检测,差异有统计学意义(P <0. 05)。结论Cys C、Um Alb/Ucr及β2-MG作为T2DN早期诊断的重要指标,其联合应用敏感性、诊断符合率均显著优于单项检测。

Objective To investigate the application value of serum cystatin C(CysC),urinary microalbumin/urinary creatinine(UmAlb/Ucr)andβ2 microglobulin(β2 MG)in early diagnosis of type 2 diabetic nephropathy(T2DN).Methods A total of 142 patients with type 2 diabetes mellitus(T2DM)who were admitted and treated in our hospital from February 2015 to Februray 2017 were enrolled as research objects,who were divided into observation group A(simple T2DM,n=62),observation group B(early T2DN,n=47),and observation group C(T2DN,n=33),at the same time,the other 40 healthy subjects who received physical examination in our hospital were enrolled as control group.The levels of CysC,UmAlb/Ucr andβ2 MG were detected and compared among groups,and the accuracy of combination detection of three indexes or simple index detection was analyzed.Results The levels of CysC,UmAlb/Ucr andβ2 MG in observation group A,observation group B and observation group C were significantly higher than those in control group,and the levels of CysC,UmAlb/Ucr andβ2 MG in observation group B and observation group C were significantly higher than those in observation group A,moreover,the levels of CysC,UmAlb/Ucr andβ2 MG in observation group C were significantly higher than those in observation group B(P<0.05).The detection rates of single index and combination detection of three indexes in control group,observation group A,observation group B and observation group C were gradually increased(P<0.05).The detection rate of combination detection of three indexes was significantly higher than that by single index detection(P<0.05).The sensitivity(94.62%),specificity(97.15%)and diagnostic accordance rate(95.78%)of combination detectoon of CysC,UmAlb/Ucr andβ2 MG were significantly higher than those by single index detection(P<0.05).Conclusion As the important indicators in early diagnosis of T2DN,the sensitivity and diagnostic accordance rate of combination detection of CysC,UmAlb/Ucr andβ2 MG are superior to those by single index detection.