血清胱抑素C、β_(2)-微球蛋白及视黄醇结合蛋白检验在早期糖尿病肾病中的应用分析

Analysis of serum cystatin C,β_(2)-microglobulin and retinol binding protein in early diabetic nephropathy

目的分析血清胱抑素C(Cys C)、β_(2)-微球蛋白(β_(2)-MG)及视黄醇结合蛋白(RBP)检验在早期糖尿病肾病(DN)患者中的应用价值。方法选取51例早期DN患者作为研究组,另选取同期50例单纯2型糖尿病患者作为对照组。检测并比较两组患者的血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)],Cys C、β_(2)-MG、RBP、尿微量白蛋白(mAlb)水平;比较两组Cys C、β_(2)-MG、RBP的异常率;比较Cys C、β_(2)-MG、RBP单独检验与三项指标联合检验早期DN的敏感度及特异度;并分析早期DN患者Cys C、β_(2)-MG、RBP与mAlb的相关性。结果研究组HbA1c、2 h PG、FPG水平分别为(8.11±1.56)%、(13.14±2.08)mmol/L、(9.04±2.56)mmol/L,均高于对照组的(6.32±1.45)%、(7.94±1.87)mmol/L、(6.40±1.80)mmol/L,差异有统计学意义(P<0.05)。研究组Cys C、β_(2)-MG、RBP及m Alb水平分别为(1.22±0.16)mg/L、(3.84±0.48)mg/L、(88.35±12.10)mg/L、(90.50±8.48)mg/24 h,均高于对照组的(0.84±0.15)mg/L、(1.65±0.36)mg/L、(50.55±10.00)mg/L、(25.05±2.00)mg/24 h,差异有统计学意义(P<0.05)。研究组患者Cys C、β_(2)-MG、RBP的异常率分别为68.63%、64.71%、58.82%,均高于对照组的30.00%、24.00%、20.00%,差异有统计学意义(P<0.05)。Cys C、β_(2)-MG、RBP三项指标联合检验早期DN的敏感度及特异度均高于Cys C、β_(2)-MG、RBP单独检验,差异有统计学意义(P<0.05)。经Pearson相关性分析显示,早期DN患者的Cys C、β_(2)-MG、RBP水平与mAlb水平呈正相关(r=0.689、0.615、0.586,P<0.05)。结论Cys C、β_(2)-MG、RBP在早期DN患者检验中具有一定的临床应用价值,且三项指标联合检测的敏感度与特异度较高,为疾病诊疗工作提供了可靠的参考依据,适于临床应用与推广。

Objective To analyze the value of serum cystatin C(Cys C),β_(2)-microglobulin(β_(2)-MG)and retinol binding protein(RBP)in early diabetic nephropathy(DN).Methods 51 patients with early DN were selected as the research group,and 50 patients with simple type 2 diabetes during the same period were selected as the control group.The blood glucose indexes[fasting plasma glucose(FPG),2 h postprandial glucose(2 h PG),glycosylated hemoglobin(HbA1c)]of the two groups were detected and compared.The levels of Cys C,β_(2)-MG,RBP,urinary microalbumin(mAlb),and the abnormal rate of Cys C,β_(2)-MG and RBP were compared between the two groups.The sensitivity and specificity of Cys C,β_(2)-MG and RBP alone and in combination for detection of early DN were compared.The correlation between Cys C,β_(2)-MG,RBP and mAlb in patients with early DN was analyzed.Results The levels of HbA1c,2 h PG,and FPG were(8.11±1.56)%,(13.14±2.08)mmol/L,and(9.04±2.56)mmol/L in the research group,which were higher than those of(6.32±1.45)%,(7.94±1.87)mmol/L,and(6.40±1.80)mmol/L in the control group,and the differences were statistically significant(P<0.05).The levels of Cys C,β_(2)-MG,RBP and mAlb were(1.22±0.16)mg/L,(3.84±0.48)mg/L,(88.35±12.10)mg/L and(90.50±8.48)mg/24 h in the research group,which were higher than those of(0.84±0.15)mg/L,(1.65±0.36)mg/L,(50.55±10.00)mg/L and(25.05±2.00)mg/24 h in the control group,and the differences were statistically significant(P<0.05).The abnormal rates of Cys C,β_(2)-MG and RBP were 68.63%,64.71%and 58.82%in the researcch group,which were higher than those of 30.00%,24.00%and 20.00%in the control group,and the differences were statistically significant(P<0.05).The sensitivity and specificity of the combined detection of Cys C,β_(2)-MG,and RBP for early DN were higher than those of Cys C,β_(2)-MG,and RBP alone,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that the levels of Cys C,β_(2)-MG,and RBP were positively correlated with mAlb levels in patients with early DN(r=0.689,0.615,0.586;P<0.05).Conclusion Cys C,β_(2)-MG and RBP have certain clinical application value in the detection of early DN patients,and the sensitivity and specificity of the combined detection of the three indicators are high,which provides a reliable reference basis for disease diagnosis and treatment,and is suitable for clinical promotion.