同型半胱氨酸、胱抑素C、视黄醇结合蛋白联合检验判断早期糖尿病肾病的研究

Study on the Diagnosis of Early Diabetic Nephropathy by the Combined test of Homocysteine,Cystatin C and Retinol Binding Protein

目的 对同型半胱氨酸(homocysteine,Hcy)、胱抑素C(cystatin C,CysC)和视黄醇结合蛋白(retinol binding protein,RBP)联合检验判断糖尿病(diabetes mellitus,DM)早期肾病进行分析。方法 选取2021年1月—2022年12月在湖北省十堰市房县人民医院接受治疗的126例早期DM肾病患者作研究对象,根据24 h尿蛋白量对其进行分组(A组63例:24 h尿蛋白量<150 mg;B组63例:24 h尿蛋白量150~300 mg),再选取同一时间在本院体检的健康者60例作对照组,对3组Hcy、CysC和RBP水平,所有入检者单项检验准确率和联合检验准确率进行对比分析。结果 B组患者的Hcy水平、CysC水平、RBP水平明显高于A组和对照组,差异有统计学意义(P<0.05);A组患者3项指标水平高于对照组,差异有统计学意义(P<0.05)。Hcy检验准确率(59.14%)、CysC检验准确率(58.60%)、RBP检验准确率(58.06%)、三者联合检验准确率(75.27%),联合检测准确率明显高于单一检测,差异有统计学意义(P<0.05)。结论 为尽早判断DM患者是否属于早期DM肾病,可采取Hcy、CysC及RBP联合检测的方式,检查结果准确率高,对患者后期治疗也有积极作用,建议临床使用。

Objective To analyze the detection of homocysteine(Hcy),cystatin C(CysC) and retinol-binding protein(RBP) in early nephropathy of diabetes(DM).Methods A total of one hundred and twenty-six patients with early DM nephropathy who received treatment in Fangxian People's Hospital of Shiyan City,Hubei Province from January 2021 to December 2022 as the study subjects.They were grouped according to 24-hour urinary protein volume(63 cases in group A:24 h urinary protein volume150 mg,63 cases in group B:24 h urinary protein volume of 150-300 mg).then sixty healthy subjects who underwent physical examination in the hospital at the same time were selected as control group.Hcy,CysC and RBP levels,single test accuracy and combined test accuracy of the three groups were compared and analyzed.Results The levels of Hcy,CysC,and RBP in group B patients were significantly higher than those in group A and the control group,and the difference was statistically significant(P<0.05).The levels of three indicators in group A patients were also higher than those in the control group,and the difference was statistically significant(P<0.05).The accuracy of Hcy was 59.14%,CysC was 58.60%,RBP was 58.06%,and the combined accuracy of the three was 75.27%.The accuracy of the combined detection was significantly higher than that of the single detection,and the difference was statistically significant(P<0.05).Conclusion In order to determine whether DM patients belong to early stage DM nephropathy as soon as possible,the combined detection of Hcy,CysC and RBP can be adopted,which has high accuracy and positive effect on the later treatment of patients,and it is recommended to be recommended in clinical practice.