胱抑素C与超敏C反应蛋白联合α1微球蛋白检测对糖尿病肾病的预后研究

Serum Cys-C, hs-CRP, Uα1-MG levels of alpha value assessment of renal function in patients with diabetic nephropathy damage and prognosis

目的探讨血清胱抑素C(Cys-C)、超敏C反应蛋白(hs-CRP)联合尿α1微球蛋白(Uα_1-MG)检测对糖尿病肾病患者肾功能损伤及预后评估价值。方法选取四川大学华西医院收治127例糖尿病患者(试验组)和体检健康者90例(对照组),采集清晨空腹外周静脉血及晨尿,进行血清Cys-C、hs-CRP和Uα_1-MG检测。比较试验组与对照组以及试验组不同预后检测血清Cys-C、hs-CRP和Uα_1-MG差异,采用受试者工作特征曲线分析三项指标单项及联合检测对糖尿病肾病的预后价值。结果试验组Cys-C、hs-CRP和Uα_1-MG检测水平均高于对照组(t=2.365、5.291、6.380,P<0.05)。终末期肾脏病患者入院时Cys-C、hs-CRP和Uα_1-MG检测水平均高于病情缓解或无进展者,差异有统计学意义(t=8.224、14.281、10.397,P<0.01)。Cys-C、hs-CRP和Uα_1-MG联合检测对糖尿病肾病患者预后评估的AUC为0.874、敏感性为88.18%、特异性为76.37%、阳性预测值为81.89%,高于三项指标单独检测。结论血清Cys-C、hs-CRP和Uα_1-MG联合检测可用于评估糖尿病肾病患者预后,为糖尿病肾病的肾损害诊治和病情监测提供依据。

Objective To investigate the value of serum cystatin C(Cys-C),high-sensitivity C-reactive protein(hs-CRP) and Urinary Alpha 1 Microglobulin(Uα1-MG) in diabetic nephropathy(DN) patients. Methods Treatment of 127 patients with diabetes mellitus(test teaml group) by renal internal medicine in our hospital and 90 healthy persons(control group).Fasting venous blood and morning urine were collected.Serum Cys-C, hs-CRP and Uα1-MG.The results of serum Cys-C,hs-CRP and Uα1-MG.were compared between the trial group and the control group, as well as the different prognosis of the trial group.The prognostic value of single and combined detection of three indexes in DN was analyzed by using the operating characteristic curve. Results The levels of Cys-C, hs-CRP and Uα1-MG in the test teaml group were higher than those in the control group(t=2.365, 5.291, 6.380, P<0.05).The levels of Cys-C,hs-CRP and Uα1-MG at admission in ESRD patients were higher than those in DN patients with remission or no progress(t=8.224, 14.281, 10.397, P<0.01).Prognostic Evaluation of Diabetic Nephropathy patients by combined Detection of Cys-C,hs-CRP and Uα1-MG AUC was 0.874, sensitivity was 88.18%, specificity was 76.37%, positive predictive value was 81.89%, which was higher than that of three individual tests. Conclusions The combined detection can be used to evaluate the prognosis of patients with diabetic nephropathy and provide evidence for the diagnosis and treatment of diabetic nephropathy.