尿ACR和血清胱抑素C与β2-微球蛋白对糖尿病早期肾损伤的诊断价值

Diagnostic value of urine ACR,serum cystatin C andβ2-microglobulin for early diabetic renal injury

目的探讨血清胱抑素C(Cys-C)、β2-微球蛋白(β2-MG)、尿微量白蛋白/肌酐比值(ACR)对糖尿病早期肾损伤的诊断价值。方法选择2022年1月—2023年5月河源市源城区人民医院收治的70例糖尿病患者作为研究对象,根据是否发生早期肾损伤分为早期肾损伤组(35例)和非早期肾损伤组(35例);另外选择同期该院35名健康体检者作为对照组。检测所有研究对象Cys-C、β2-MG、尿ACR,比较各组上述指标水平和阳性检出率,分析各指标单独与联合检测对糖尿病早期肾损伤的诊断效能。结果早期肾损伤组Cys-C、β2-MG、尿ACR水平均明显高于非早期肾损伤组和对照组〔Cys-C(mg/L):1.27±0.02比1.11±0.04、1.06±0.05,β2-MG(mg/L):3.19±0.13比2.40±0.10、1.20±0.19,尿ACR(mg/g):33.25±0.15比26.45±0.13、12.05±2.11,均P<0.05〕。早期肾损伤组Cys-C、β2-MG、尿ACR单独及联合检测的阳性检出率均明显高于非早期肾损伤组和对照组(Cys-C:82.82%比40.00%、5.72%,β2-MG:85.71%比28.57%、0.00%,尿ACR:88.57%比45.71%、2.86%,联合检测:94.29%比54.29%、11.43%,均P<0.05)。Cys-C、β2-MG、尿ACR联合检测的准确度、灵敏度、特异度均明显高于单独检测。结论Cys-C、β2-MG、尿ACR联合检测在早期糖尿病肾损伤中具有较高价值,值得推广应用。

Objective To study the diagnostic value of serum cystatin C(Cys-C),β2-microglobulin(β2-MG)and urine albumin/creatinine ratio(ACR)for early diabetic renal injury.Methods The patients with diabetes admitted in Heyuan City Yuancheng District People's Hospital from January 2022 to May 2023 were chosen as research objects.The patients were assigned to early renal injury group(35 cases)and non-early renal injury group(35 cases).During the same period,35 healthy checkups were set as control group.Serum levels of Cys-C,β2-MG and urine ACR were detected.The levels and positive detectable rates in each group were compared,and the diagnostic efficacy of each indicator individually and jointly for diabetic renal injury was analyzed.Resultsβ2-MG,Cys-C and urine ACR levels in early renal injury group were lower than those in non-early renal injury group and control group[Cys-C(mg/L):1.27±0.02 vs.1.11±0.04,1.06±0.05,β2-MG(mg/L):3.19±0.13 vs.2.40±0.10,1.20±0.19,urine ACR(mg/g):33.25±0.15 vs.26.45±0.13,12.05±2.11,all P<0.05].The positive detectable rates ofβ2-MG,Cys-C and urine ACR in early renal injury group were lower than those in non-early renal injury group and control group(Cys-C:82.82%vs.40.00%,5.72%,β2-MG:85.71%vs.28.57%,0.00%,urine ACR:88.57%vs.45.71%,2.86%,combination:94.29%vs.54.29%,11.43%,all P<0.05).The diagnosis accuracy,sensitivity and specificity of combined examination were higher than those ofβ2-MG,Cys-C or urine ACR.Conclusion The combined examinations of urine ACR,serum Cys-C andβ2-MG are clinically proven to be effective for the diagnosis of early diabetic renal injury.