血清淀粉样蛋白A(SAA)、胱抑素C(CysC)、尿清蛋白肌酐比值(ACR)联合检测在早期糖尿病肾病中的诊断价值

Diagnostic Value of combined Detection of Serum Amyloid A(SAA),Cystatin C(CysC)and Urinary Albumin Creatinine Ratio(ACR)in Early Diabetic Nephropathy

目的探讨血清淀粉样蛋白A(SAA)、胱抑素C(CysC)、尿清蛋白肌酐比值(ACR)联合检测在早期糖尿病肾病中的诊断意义。方法选取我院(2017年1月至2019年1月)收治的45例2型糖尿病患者为2型糖尿病组,选取同时期我院收治的45例糖尿病肾病患者为糖尿病肾病组,另选取同时期来我院体检健康者45例为健康对照组,对比三组研究对象尿ACR和血清eGFR、SAA、CysC水平,分析糖尿病肾病组尿ACR与血清SAA、CysC的相关性,并统计尿ACR和血清eGFR、SAA单项检测诊断与联合检测诊断糖尿病肾病的受试者工作特征。结果健康对照组尿ACR和血清eGFR、SAA、CysC水平明显低于2型糖尿病组和糖尿病肾病组(P<0.05);2型糖尿病组尿ACR和血清eGFR、SAA、CysC水平明显低于糖尿病肾病组(P<0.05)。糖尿病肾病组尿ACR与血清SAA、CysC由明显相关性(P<0.05)。三项指标联合检测诊断糖尿病肾病的曲线下面积、特异度、敏感度明显高于各指标单项或二者联合检测(P<0.05)。结论血清淀粉样蛋白A(SAA)、胱抑素C(CysC)、尿清蛋白肌酐比值(ACR)联合检测在早期糖尿病肾病中的诊断意义较高,优于各指标单项或二者联合检测,值得应用。

Objective To investigate the diagnostic value of serum amyloid A(SAA),cystatin C(CysC)and urinary albumin creatinine ratio(ACR)in early diabetic nephropathy.Method Forty-fi ve patients with type 2 diabetes admitted to our hospital(from January 2017 to January 2019)were selected for type 2 diabetes.The 45 patients with diabetic nephropathy admitted to our hospital at the same time were included in the diabetic nephropathy group.45 healthy subjects in our hospital were healthy controls.The levels of urinary ACR and serum EGFR,SAA and CysC were compared between the three groups.The correlation between urinary ACR and serum SAA and CysC in diabetic nephropathy group was analyzed.Urinary ACR and serum eGFR were counted,SAA single test diagnosis and joint test to diagnose the working characteristics of patients with diabetic nephropathy.Results The levels of urinary ACR and serum eGFR,SAA and CysC in healthy control group were signifi cantly lower than those in type 2 diabetes group and diabetic nephropathy group(P<0.05).The levels of urinary ACR and serum eGFR,SAA and CysC in type 2 diabetes group were signifi cantly lower than those in diabetic group.Kidney disease group(P<0.05).Urinary ACR in the diabetic nephropathy group was signifi cantly correlated with serum SAA and CysC(P<0.05).The area,specifi city and sensitivity of the three indicators combined with the diagnosis and diagnosis of diabetic nephropathy were signifi cantly higher than the single index or the combination of the two(P<0.05).Conclusion The combination of serum amyloid A(SAA),cystatin C(CysC)and urinary albumin creatinine ratio(ACR)has a higher diagnostic value in early diabetic nephropathy,which is superior to each index or both.It is worth applying.