探讨西藏地区2型糖尿病肾病患者早期诊断指标的临床价值

Clinical Value of Indexes for Early Diagnosing Patients with Type 2 Diabetic Nephropathy

目的探讨西藏地区糖尿病肾脏疾病患者的早期诊断指标的临床价值。方法选取我院2019年1~6月收治的藏族2型糖尿病患者90例,分为A组(正常白蛋白尿)、B组(微量白蛋白尿)、C组(临床白蛋白尿),每组各30例,其中,同时选取同时期的健康人30例作为D组。检测各组肌肝、血清胱抑素C、尿β2-微球蛋白水平,采用Pearson分析上述指标与估算的肾小球滤过率的相关性;采用ROC曲线分析上述指标的诊断价值。结果肌肝、血清胱抑素C和尿β2-微球蛋白水平由高到低依次是C组、B组、A组、D组,各组间差异均有统计学意义(P<0.001);各组的肌肝、血清胱抑素C和尿β2-微球蛋白均与肾小球滤过率呈负相关。肌肝、血清胱抑素C和尿β2-微球蛋白的AUC分别0.757,0.879和0.954。三项指标联合的AUC为0.970。结论肌肝、血清胱抑素C和尿β2-微球蛋白可用于糖尿病肾病的早期诊断,且三者联合检测的诊断价值更高。

Objective:To investigate the clinical value of indexes for early diagnosis patients with type 2 diabetic nephropathy.Methods:Totally,90 patients with type 2 diabetes were admitted and treated in our hospital from January 2019 to June 2019.They were divided into A group(normal-albuminuria),B group(micro-albuminuria),C group(clinic-albuminuria)with 30 patients in each group.Meanwhile,30 healthy were selected as D group.The serum CREA,Cys-C,andβ2-MG were detected.The correlation between eGFR and the above-mentioned indexes by Pearson Correlations.The diagnostic value of the above-mentioned indexes were analyzed by ROC curve.Results:The levels of serum CREA,Cys-C,andβ2-MG in four groups from highest to lowest were C group,B group,A group and D group.There was a negative correlation between eGFR and the above-mentioned indexes.The AUC were 0.757 for serum CREA,0.879 for Cys-C,and 0.954 forβ2-MG.The AUC was 0.970 for the combination of three indexes.Conclusions:The combination of three indexes is better in diagnosis of type 2 diabetic nephropathy,although the levels of serum CREA,Cys-C,andβ2-MG can be used for early diagnosis.