血清胱抑素C在早期糖尿病患者肾小球损害诊断中的应用价值

Application value of serum cystatin C in diagnosis of glomerular damage in patients with early diabetic mellitus

目的探讨血清胱抑素C(Cys C)在早期糖尿病(DM)患者肾小球损害诊断中的应用价值。方法回顾性分析2016年3月～2018年3月在我院就诊的196例DM患者,将合并糖尿病肾病(DN)的患者定为观察组(102例),单纯DM患者定为对照组(94例)。比较两组患者的Cys C、尿素氮(BUN)、血肌酐(SCr)水平,用受试者工作特征曲线(ROC)评估上述指标对DN的诊断价值。结果观察组的Cys C、BUN、SCr水平显著高于对照组,差异有统计学意义(P<0.05)。ROC曲线分析显示,血清Cys C对DN的诊断效能显著高于BUN、SCr(P<0.05),其曲线下面积(AUC)分别为0.885、0.715、0.748。Youden指数提示,Cys C、BUN、SCr表达水平诊断DN的最佳截点分别为≥0.797 mg/L、≥7.273 mmol/L、≥127.741μmol/L。CysC的准确率、灵敏度、特异度、阳性预测值和阴性预测值等诊断指标显著高于BUN、SCr,差异均有统计学意义(P<0.05)。结论在早期DM患者肾损害的诊断中,CysC的灵敏度和特异度高,值得临床推广。

Objective To explore the application value of cystatin C(CysC)in in diagnosis of glomerular damage in patients with early diabetic mellitus(DM).Methods All of 196 patients with DM treated in our hospital from March 2016 to March 2018 were retrospectively analyzed,and the patients with diabetic nephropathy(DN)were set as the observation group(102 cases)while patients with simple DM were set as the control group(94 cases).CysC,BUN and SCr level inpatients between the two groups were compared,and ROC curve was used to evaluate the diagnostic value of the above-mentioned indexes for DN.Results The level of CysC,BUN and SCr in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the diagnostic efficacy of serum CysC for DN was significantly higher than that of BUN and SCr(P<0.05),the AUC was 0.885,0.715,0.748 respectively.The Youden index indicated that the best cut-off points of CysC,BUN and SCr expression level for diagnosis of DN was≥0.797 mg/L,≥7.273 mmol/L and≥127.741μmol/L respectively.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of CysC were significantly higher than those of BUN and sCR,and the differences were statistically significant(P<0.05).Conclusion CysC has higher sensitivity and specificity in the diagnosis of glomerular damage in patients with early DM.It is worthy of clinical promotion.