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目的 测定 2型糖尿病早期肾病患者血清西司他汀浓度 (CystatinC ,CysC) ,观察其变化情况 ,以评价糖尿病早期肾病肾小球功能。方法 住院的 14 1例 2型糖尿病患者 ,根据 2 4小时尿微量白蛋白排泄率 (Urinealbuminexcretionrate ,UAER)分为三组 :A组 ,UAER <30mg 2 4h ;B组 ,UAER 30～ 30 0mg 2 4h ;C组 ,UAER≥ 30 0mg 2 4h。采用散率散射比浊法对所有患者测定CysC ,并与内生肌酐清除率 (creatinineclearancerate ,Ccr)比较。结果 与正常对照组比较 ,B、C两组UAER、CysC均高于正常对照组 ,Ccr低于正常对照组 (P <0 . 0 1) ,A组与正常对照相似 (P >0 . 0 5 ) ;3组之间比较 ,CysC、UAER值C组明显高于B、A组 ,B组高于A组 ;Ccr值C组低于B、A组 ,B组低于A组 (P <0 . 0 1)。相关分析显示 ,CysC与UAER呈显著正相关 ,与Ccr呈显著负相关 (P <0 . 0 1)。结论 CysC能较准确反映肾小球滤过功能 ,而且测定只需一份血标本 ,不需收集尿标本 ,方法简便、快捷。
Objective To determine the concentration of serum cstatin (CysC) in type 2 diabetic patients with early nephropathy and to observe the changes of glomerular function in early stage of diabetic nephropathy. Methods A total of 141 hospitalized patients with type 2 diabetes mellitus were divided into three groups according to 24-hour urinary albumin excretion rate (UAER): group A, UAER <30 mg for 24 h, group B, UAER 30-30 mg for 24 h ; C group, UAER≥30 0mg 2 4h. CysC was measured in all patients by scatter nephelometry and compared with creatinineclearance rate (Ccr). Results Compared with normal control group, UAER and CysC in group B and group C were significantly higher than those in control group, while Ccr was lower than that in control group (P <0.01). Group A was similar to that in control group (P> 0.05) ); The CysC and UAER values in group C were significantly higher than those in group B and A, while those in group B were higher than those in group A. Ccr was lower in group C than in group B and group A, but lower in group B than in group A (P <0 . 0 1). Correlation analysis showed that CysC was positively correlated with UAER and negatively correlated with Ccr (P <0.01). Conclusion CysC can accurately reflect glomerular filtration function, and the determination of only one blood specimen, no need to collect urine samples, the method is simple and quick.