血清HCY、Cys-C和β2-MG联合检测在2型糖尿病肾病早期诊断中的价值

The Value of Combined Serum HCY,Cys-C andβ2-MG Tests in the Early Diagnosis of Type 2 Diabetic Nephropathy

目的研究血清同型半胱氨酸(homocysteine,HCY)、胱抑素C(cystatin C,Cys-C)、β2微球蛋白(β2-microglobulin,β2-MG)联合检测在2型糖尿病肾病早期诊断中的应用价值。方法选择2019年1月—2021年1月龙岩市第二医院收治的400例2型糖尿病患者作为研究对象,根据患者Mogenson检查结果将其分为单纯糖尿病患者组(n=105)、早期糖尿病肾病患者组(n=152)、临床糖尿病肾病患者组(n=143),选择同期前来体检的健康对象200名作为对照组。所有对象均接受HCY、Cys-C、β2-MG检测,通过比较不同组别检测结果差异,计算HCY、Cys-C、β2-MG联合检测对2型糖尿病肾病的诊断效能。结果单纯糖尿病患者组、早期糖尿病肾病患者组、临床糖尿病肾病患者组与对照组HCY、Cys-C、β2-MG的水平比较,差异有统计学意义(P<0.05);单纯糖尿病患者组、早期糖尿病肾病患者组、临床糖尿病肾病患者组、对照组中HCY、Cys-C、β2-MG的阳性率比较,差异有统计学意义(P<0.05);HCY、Cys-C、β2-MG联合诊断对2型糖尿病肾病的诊断敏感度、特异度、阳性预测值、阴性预测值高于上述指标单独检测,差异有统计学意义(P<0.05)。结论血清HCY、Cys-C、β2-MG联合检测在2型糖尿病肾病患者的诊断中具有积极作用,能有效判断患者肾脏损伤程度且对2型糖尿病肾病的病情进展亦有积极的评估价值。

Objective To study the value of combined serum homocysteine(HCY),cystatin C(Cys-C)andβ2-microglobulin(β2-MG)assay in the early diagnosis of type 2 diabetic nephropathy.Methods 400 cases of 2 diabetic patients admitted to the Longyan Second Hospital from January 2019 to January 2021 were selected as the study subjects.According to the results of Mogenson examination of patients,they were divided into the group of patients with simple diabetes(n=105),the group of patients with early diabetic nephropathy(n=152),and the group of patients with clinical diabetic nephropathy(n=143).And 200 healthy subjects who came for physical examination in the same period were selected as the control group.All subjects were tested for HCY,Cys-C andβ2-MG,and the diagnostic efficacy of the combined test for HCY,Cys-C andβ2-MG on type 2 diabetic nephropathy was calculated by comparing the differences in the test results between different groups.Results The levels of HCY,Cys-C,andβ2-MG in the group of patients with diabetes mellitus alone,the group of patients with early diabetic nephropathy,the group of patients with clinical diabetic nephropathy and the control group were compared,the difference was statistically significant(P<0.05).The positive rates of HCY,Cys-C,andβ2-MG in the group of patients with diabetes mellitus alone,the group of patients with early diabetic nephropathy,the group of patients with clinical diabetic nephropathy,and the control group were compared,the differences were statistically significant(P<0.05).The sensitivity,specificity,positive predictive value,and negative predictive value of combined diagnosis of HCY,Cys-C,andβ2-MG for the diagnosis of type 2 diabetic nephropathy were higher than those of the above indicators tested separately,and the differences were statistically significant(P<0.05).Conclusion The combined test of serum HCY,Cys-C andβ2-MG has a positive effect in the diagnosis of patients with type 2 diabetic nephropathy.It can effectively determine the degree of kidney damage and has a positive value in assessing the progression of type 2 diabetic nephropathy.