血清胱抑素C、肌酐、尿素联合检测在糖尿病肾病诊断及肾功能损害预测中的价值

Value of Combined Detection of Serum Cystatin C,Creatinine and Urea in the Diagnosis of Diabetic Nephropathy and the Prediction of Renal Dysfunction

目的研究血清胱抑素C(Cys-C)、肌酐(Cr)、尿素(UREA)联合检测在糖尿病肾病(DN)诊断及肾功能损害预测中的应用价值。方法选取2021年1月-2023年3月溧阳市人民医院收治的50例DN患者设为DN组,另选取同期收治的50例单纯糖尿病患者设为DM组,比较两组血清Cys-C、Cr、UREA水平及各项指标的阳性检出率,并分析Cys-C、Cr、UREA单独及联合检测对DN的诊断价值,另比较各项指标在不同肾损伤分级中的差异。结果DN组血清Cys-C、Cr、UREA水平高于DM组(P<0.05);DN组Cys-C、Cr、UREA阳性检出率均高于DM组(P<0.05),且Cys-C、Cr、UREA联合检测的阳性检出率高于其单独检测(P<0.05)。经ROC曲线分析显示,Cys-C、Cr、UREA单独及联合检测对DN均具有确切诊断价值,其中Cys-C、Cr、UREA联合诊断DN的AUC值大于其单独检测(P<0.05)。不同肾损伤分级患者Cys-C、Cr、UREA水平比较,差异有统计学意义(P<0.05),其中由高至低依次为Ⅴ期>Ⅳ期>Ⅲ期>Ⅱ期>Ⅰ期。结论血清Cys-C、Cr、UREA联合检测对DN具有较高诊断价值,在肾功能损害的预测评估中可发挥确切作用。

Objective To study the application value of combined detection of serum cystatin C(Cys-C),creatinine(Cr)and urea(UREA)in the diagnosis of diabetic nephropathy(DN)and the prediction of renal function damage.Methods Fifty patients with DN admited to Liyang People's Hospital from January 2021 to March 2023 were selected as the DN group,and 50 patients with simple diabetes admitted to the same period were selected as the DM group.The levels of serum Cys-C,Cr and UREA and the positive detection rate of each index were compared between the two groups.The diagnostic value of Cys-C,Cr and UREA alone and in combination for DN was analyzed,and the diferences of each index in different renal injury grades were compared.Results The levels of serum Cys-C,Cr and UREA in DN group were higher than those in DM group(P<0.05).The positive detection rates of Cys-C,Cr and UREA in DN group were higher than those in DM group(P<0.05),and the positive detection rate of combined detection of Cys-C,Cr and UREA was higher than that of single detection(P<0.05).The ROC curve analysis showed that Cys-C,Cr,UREA alone and combined detection had definite diagnostic value for DN,and the AUC value of Cys-C,Cr and UREA combined diagnosis of DN was greater than that of their separate detection(P<0.05).The levels of Cys-C,Cr and UREA in patients with different renal injury grades were significantly diferent(P<0.05),and the order from high to low was stage V>stage IV>stage II>stage Ⅱ>stageⅠ.Conclusion The combined detection of serum Cys-C,Cr and UREA has high diagnostic value for DN,and can play an exact role in the prediction and evaluation of renal function damage.