血清CysC联合尿TRF、β2-MG、NAG检测在妊娠期糖尿病肾损伤早期诊断中的价值

Value of combined detection of serum CysC and urine TRF,β2-MG,NAG in the early diagnosis of gestational diabetes mellitus patients with early renal injury

目的探讨血清胱抑素C(CysC)联合尿转铁蛋白(TRF)、β2微球蛋白(β2-MG)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)检测对妊娠期糖尿病(GDM)患者早期肾损伤的诊断价值。方法将2016年1月至2017年6月济宁医学院附属滕州市中心人民医院内分泌科收治的76例GDM患者纳入研究,选择同期正常妊娠妇女70例(正常妊娠组)、健康体检育龄未孕女性62例(对照组)。血清CysC,尿TRF、β2-MG应用免疫比浊法检测;尿NAG应用速率法检测。结果GDM组血清CysC,尿TRF、β2-MG、NAG明显高于其他两组(P<0.05);除血清CysC外,正常妊娠组尿TRF、β2-MG、NAG均高于对照组(均P<0.05);伴随孕周增加,四项指标水平均呈上升趋势,GDM晚孕组四项指标高于其他两组(P<0.05);GDM中孕组和正常妊娠晚孕组四项指标水平均高于正常妊娠中孕组(均P<0.05);GDM中孕组尿TRF、β2-MG、NAG水平高于正常妊娠晚孕组(均P<0.05);GDM患者四项指标联测结果阳性率(91.4%)高于血清CysC、尿TRF、β2-MG和NAG各单项单独检测(67.7%、61.4%、72.9%、48.6%)(χ^2=13.75、17.49、8.23、30.61,P<0.05)。结论CysC联合TRF、β2-MG、NAG检测可灵敏诊断GDM患者早期肾损伤,连续监测可动态反映疾病进展。

Objective To investigate the diagnostic effect of serum cystatin C(CysC)combined with urinary transferrin(TRF),β2-microglobulin(β2-MG)and N-acetyl-beta D-glucosaminidase(NAG)combined detection on gestational diabetes mellitus(GDM)patients with early renal injury.Methods Seventy-six patients with GDM in Affilated Tengzhou Central People's Hospital of Jining Medical University from January 2016 to June 2017 were enrolled for the observation group,70 cases of normal pregnant women were chosen during the same period as normal pregnancy group,and 62 healthy non-pregnant women as control group.Serum CysC,urine TRF and B 2-MG were detected by immunoturbidimetry,and urine NAG was detected by applied rate method.Results The concentration of CysC,TRF,β2-MG,NAG of the GDM group were higher than those of the other two groups(all P<0.05);the concentration of TRF,β2-MG,NAG of the normal pregnant group were higher than those of the control group(P<0.05).With the increase of gestational age,the levels of four indicators showed an upward trend.The concentration of CysC,TRF,β2-MG,NAG of the late pregnancy GDM group were significantly higher than the other two groups(all P<0.05).The concentration of CysC,TRF,β2-MG,NAG concentrations in the mid GDM pregnant group and the late normal pregnancy group were higher than those of the mid normal pregnancy group(all P<0.05).The concentration of TRF,β2-MG,NAG of the mid GDM pregnant group were higher than those of the late normal pregnancy group(P<0.05).In the GDM group,the positive rate of combined detection of CysC,TRF,β2-MG,NAG was significantly higher than those of single index detection(67.7%,61.4%,72.9%,48.6%,χ^2=13.75,17.49,8.23,30.61,P<0.05).Conclusions CysC combined with TRF,beta 2-MG and NAG can sensitively diagnose early renal injury in GDM patients,and continuous monitoring can dynamically reflect the progress of disease.