胱抑素C及α1-微球蛋白检测对糖尿病肾病诊断作用

Comparative observation of the diagnostic effect of cystatin C and α1-microglobulin on diabetic nephropathy

目的:分析胱抑素C(CysC)及α1-微球蛋白(α1-MG)检测对糖尿病肾病的诊断作用。方法:选取2017年8月-2020年8月糖尿病肾病患者240例,作为微量清蛋白尿亚组和临床蛋白尿亚组(A组);同期体检健康人员200例,作为B组;同期单纯糖尿病患者372例,作为C组。各组均应用涂胶增强免疫比浊法测定血清、尿CysC和α1-MG水平。结果:A组血清CysC、α1-MG和尿CysC、α1-MG水平均高于B组和C组,差异有统计学意义(P<0.05);A组的临床蛋白尿亚组上升十分明显,差异有统计学意义(P<0.05);B组血清CysC和尿CysC、α1-MG水平均明显高于C组,差异有统计学意义(P<0.05)。A组血清CysC、α1-MG和尿CysC、α1-MG的异常率均高于B组和C组,且C组异常率均高于B组,差异均有统计学意义(P<0.05);A组的临床蛋白尿亚组异常率最为明显,差异有统计学意义(P<0.05)。结论:CysC作为一种临床较为理想的肾小球滤过率评定标准,可将其作为早期诊断糖尿病肾病肾小球滤过功能损伤的关键依据,尿α1-MG是肾小管受损的标志物,能够及早发现糖尿病肾病合并肾小管病变,两者联合检测,能够在早期阶段发现糖尿病病程中肾功能受损情况。

Objective:To analyze the diagnostic effect of cystatin C andα1-microglobulin on diabetic nephropathy.Methods:From August 2017 to August 2020,240 patients with diabetic nephropathy were selected as the group A(the microalbuminuria subgroup and the clinical albuminuria subgroup).200 healthy persons undergoing physical examination during the same period were selected as the group B.During the same period,372 patients with simple diabetes were regarded as the group C.In each group,the gel-enhanced immunoturbidimetric method was applied to determine the serum and urinary cystatin C andα1-microglobulin levels.Results:The serum CysC,serumα1-MG,urine CysC,and urineα1-MG levels in the group A were higher than those in the group B and C,the difference was statistically significant(P<0.05).The clinical proteinuria subgroup increased significantly,and the difference was significant(P<0.05).The serum CysC,urine CysC,and urine-α1-MG levels in the group B were significantly higher than those in the group C,the difference was statistically significant(P<0.05).The abnormal rates of serum CysC,serumα1-MG,urine CysC,and urineα1-MG in the group A were higher than those in the groups B and C,and the abnormal rates in the group C were higher than those in the group B,the differences were statistically significant(P<0.05).The abnormal rate of the clinical proteinuria subgroup was the most obvious,and the difference was statistically significant(P<0.05).Conclusion:CysC,as a clinically ideal evaluation standard for glomerular filtration rate,which can be used as a key basis for early diagnosis of glomerular filtration damage in diabetic nephropathy.Urinaryα1-MG is a marker of renal tubular damage,which can detect diabetic nephropathy and renal tubular disease as early as possible.The combined measurement of the two can detect renal function damage in the course of diabetes at an early stage.