血清淀粉样蛋白A与胱抑素C和C反应蛋白联合检测在糖尿病肾病诊断中的临床价值

Clinical value of combined detection of serum amyloid A,cystatin C and C-reactive protein in the diagnosis of diabetic nephropathy

目的探讨血清淀粉样蛋白A(SAA)、胱抑素C(CysC)、C反应蛋白(CRP)联合检测在糖尿病肾病(DN)诊断中的临床价值。方法选取2019年1月至2022年12月宜春市中医院收治的单纯DM患者作为单纯DM组(n=36),DN患者作为DN组(n=68),其中DN组根据不同时期分为早期DN组(n=26)、中期DN组(n=20)、晚期DN组(n=22);另选取同期30名健康体检者作为对照组。各组均检测血清SAA、CysC和CRP水平,比较各组血清SAA、CysC和CRP水平及单独检测、联合检测的阳性检出率。结果晚期DN组血清SAA、CysC、CRP水平均明显高于中期DN组、早期DN组、单纯DM组和对照组,中期DN组高于早期DN组、单纯DM组和对照组,早期DN组高于单纯DM组和对照组,单纯DM组高于对照组,差异有统计学意义(P<0.05)。晚期DN组与中期DN组、早期DN组SAA、CysC、CRP单独检测及联合检测阳性率比较差异无统计学意义。晚期DN组、中期DN组和早期DN组SAA、CysC、CRP单独检测及联合检测阳性率均高于单纯DM组,差异有统计学意义(P<0.05);SAA、CysC、CRP单独检测及联合检测灵敏度、特异度、诊断符合率比较差异有统计学意义(P<0.05)。SAA、CysC、CRP单独检测灵敏度、特异度、诊断符合率均低于联合检测,差异有统计学意义(P<0.05)。结论在早期DN患者生化检测中,采用血清SAA、CysC和CRP联合检测能为临床诊断提供可靠依据,对早期DN患者的发展及干预具有重要意义。

Objective To investigate the clinical value of serum amyloid A(SAA),cystatin C(CysC)and C-reactive protein(CRP)combined detection in the diagnosis of diabetic nephropathy(DN).Methods Patients with simple DM admitted to Yichun Hospital of Traditional Chinese Medicine from January 2019 to December 2022 were selected as the simple DM group(n=36)and DN patients as the DN group(n=68).The DN group was divided into the early DN group(n=26),middle DN group(n=20)and late DN group(n=22)according to different periods;another 30 healthy subjects were selected as control group.Serum levels of SAA,CysC and CRP were detected in all groups.The levels of SAA,CysC and CRP in all groups were compared,and the positive detection rate of single detection and combined detection were compared.Results The levels of serum SAA and CRP in advanced DN group were significantly higher than those in the middle DN group,early DN group,simple DM group and control group,and the difference was statistically significant(P<0.05).The middle DN group were significantly higher than the early DN group,simple DM group and control group,the early DN group were significantly higher than the simple DM group and control group,the simple DM group was significantly higher than control group,and the differences were statistically significant(P<0.05).There were no significant differences in the positive rates of SAA,CysC,CRP alone and combined detection between the late DN group,the middle DN group and the early DN group.The positive rates of SAA,CysC,CRP alone and combined detection in the late DN,middle DN and early DN groups were higher than those in the simple DM group,and the differences were statistically significant(P<0.05).The sensitivity,specificity and diagnostic coincidence rate of SAA,CysC and CRP alone were lower than those of combined detection,and the differences were statistically significant(P<0.05).Conclusion In the biochemical detection of patients with early DN,the combined detection of serum SAA,CysC and CRP can provide a reliable basis for clinical diagnosis,and is of great significance for the development and intervention of patients with early DN.