HbA1c、ACR、CysC、IL-6联合检测在糖尿病肾损伤早期诊断中的应用价值分析

Value of combined detection of HbA1c, ACR, CysC and IL-6 in the early diagnosis of diabetes nephropathy

目的探究糖化血红蛋白(HbA1c)、尿微量白蛋白与尿肌酐比值(ACR)、胱抑素C(CysC)、白细胞介素-6(IL-6)联合检测在糖尿病肾病早期诊断中的应用价值。方法选择2022年2月—2023年2月本院收治的糖尿病肾病患者60例为糖尿病肾病组、单纯2型糖尿病患者20例为糖尿病组;另选择同期健康志愿者20名为对照组。检测三组研究对象HbA1c、CysC水平,免疫透射比浊法检测ACR水平,化学发光法检测血清IL-6水平,分析HbA1c、ACR、CysC、IL-6联合检测在糖尿病肾病早期诊断中的应用价值。结果糖尿病肾病组HbA1c、ACR、CysC、IL-6水平高于糖尿病组、对照组(P<0.05)。动脉狭窄、24 h尿蛋白定量高、晚期、预后不良患者HbA1c、ACR、CysC、IL-6水平高于内膜增厚、24 h尿蛋白定量低、早中期、预后良好患者(P<0.05)。HbA1c与ACR、CysC、IL-6水平呈正相关(r=557、0.492、0.538,P均=0.001);ACR与CysC、IL-6水平呈正相关(r=0.557、0.457,P均=0.001);CysC与IL-6水平呈正相关(r=0.456,P=0.001)。HbA1c、ACR、CysC、IL-6四项联合检测对糖尿病肾病早期诊断的灵敏度较高,特异度较低(P<0.05)。结论糖尿病肾病患者HbA1c、ACR、CysC、IL-6明显较高,四者水平与临床特征密切相关,四项联合检测对糖尿病肾病早期诊断具有较高应用价值。

Objective To explore the value of combined detection of glycosylated hemoglobin(HbA1c),albumin-to-creatinine ratio(ACR),cystatin C(CysC)and interleukin-6(IL-6)in the early diagnosis of diabetes nephropathy.Methods Sixty patients suffering from diabetic nephropathy who were admitted to our hospital from February 2022 to February 2023 were selected as diabetic nephropathy group,20 patients with simple type 2 diabetes were selected as the diabetes group,and 20 healthy volunteers were selected as the control group.The levels of HbA1c and CysC in the three groups were detected,the levels of ACR were detected by immunoturbidimetry,and the levels of serum IL-6 were detected by chemiluminescence.The application value of the combined detection of HbA1c,ACR,CysC and IL-6 in the early diagnosis of diabetic nephropathy was analyzed.Results The levels of HbA1c,ACR,CysC and IL-6 in diabetes nephropathy group were higher than those in diabetes group and control group(P<0.05).Patients with arterial stenosis,high 24-hour urine protein quantification,advanced stage,and poor prognosis had higher levels of HbA1c,ACR,CysC,and IL-6 than those with intimal thickening,low 24-hour urine protein quantification,early to mid stage,and good prognosis(P<0.05).HbA1c was positively correlated with the levels of ACR,CysC,and IL-6(r=557,0.492,0.538,all P=0.001);ACR was positively correlated with CysC and IL-6 levels(r=0.557,0.457,P=0.001);CysC was positively correlated with IL-6 levels(r=0.456,P=0.001).The combined detection of HbA1c,ACR,CysC and IL-6 had high sensitivity and low specificity in the early diagnosis of diabetes nephropathy(P<0.05).Conclusions The levels of HbA1c,ACR,CysC,and IL-6 in patients with diabetes nephropathy are significantly up-regulated,which are closely related to clinical characteristics.The combined tests of the four indicators have high application value for early diagnosis of diabetes nephropathy.