血清胆红素与CysC、Hcy、尿mALB联合检测在2型糖尿病肾病早期诊断中的应用价值

The Value of Combined Detection of Serum Bilirubin,CysC,Hcy,Urinary mALB in the Early Diagnosis of Type 2 Diabetic Nephropathy

目的分析血清胆红素联合胱抑素C(cystatin C,CysC)、同型半胱氨酸(homocystinemia,Hcy)、尿微量白蛋白(microalbuminuria,mALB)诊断2型糖尿病肾病(type 2 diabetic nephropathy,T2DN)的效能。方法目的选取2020年4月—2023年4月吉林市第二人民医院收治的76例T2DN患者纳入观察组,将同期收治的78例单纯2型糖尿病(type 2 diabetes mellitus,T2DM)患者纳入对照组,另将同期74名健康体检者纳入健康组,比较3组胆红素、CysC、Hcy、尿mALB的差异;并绘制ROC曲线分析上述指标单独或联合诊断T2DN的价值。结果观察组的直接胆红素、总胆红素低于对照组和健康组,CysC、Hcy、尿mALB高于对照组和健康组,差异有统计学意义(P均<0.05)。ROC结果显示,联合诊断T2DN的曲线下面积为0.930,敏感度、特异度分别98.70%、84.60%,优于单一检测结果。结论血清胆红素联合CysC、Hcy、尿mALB可有效诊断T2DN。

Objective To analyze the efficacy of serum bilirubin combined with cystatin C(CysC),homocysteine(Hcy),microalbuminuria(mALB)in the diagnosis of type 2 diabetic nephropathy(T2DN).Methods Seventy-six pa-tients with T2DN admitted to the Second People's Hospital of Jilin City from April 2020 to April 2023 were objec-tively included in the observation group,and seventy-eight patients with type 2 diabetes mellitus(T2DM)admitted to the Second People's Hospital of Jilin City during the same period were included in the control group.In addition,seventy-four healthy subjects in the same period were included in the healthy group,and the differences of bilirubin,CysC,Hcy and urinary mALB among the three groups were compared.ROC curves were drawn to analyze the value of the above indicators in the diagnosis of T2DN alone or in combination.Results Direct bilirubin and total bilirubin in observation group were lower than those in control group and healthy group,while CysC,Hcy and urinary mALB were higher than those in control group and healthy group,the differences were statistically significant(all P<0.05).ROC re-sults showed that the area under the curve of T2DN combined diagnosis was 0.930,and the sensitivity and specificity were 98.70%and 84.60%,respectively,which were better than the results of single detection.Conclusion Serum bili-rubin combined with CysC,Hcy and urinary mALB can effectively diagnose T2DN.