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目的:探讨胱抑素C(CysC)对2型糖尿病(T2DM)肾脏损伤的诊断意义。方法:对175例T2DM患者根据尿微量白蛋白排泄率(UAER)分为3组:正常蛋白尿(NA)组(UAER<30mg/24h),72例;微量蛋白尿(MA)组(UAER 30-300mg/24h),58例;临床蛋白尿(CDN)组(UAER>300mg/24h),45例;另选60例健康体检者作对照组。应用免疫透射比浊法测定血清CysC浓度,并比较各组的血清肌酐(Scr)、尿素氮(BUN)、β2-微球蛋白(β2-MG)和UAER。结果:T2DM患者5个项目的水平均明显高于对照组,差异均有统计学意义(P<0.01);MA组患者中CysC、β2-MG、UAER、Scr与对照组比较差异有统计意义(P<0.01或P<0.05);NA组患者CysC、β2-MG和UAER水平与对照组比较,差异均有统计学意义(P<0.05);CDN组患者CysC、Scr、BUN、β2-MG和UAER水平明显高于MA组和NA组,差异有统计学意义(P<0.01)。在NA组中CysC、Scr、Bun、β2-MG 4指标的异常检出率差异无统计学意义(P>0.05),但在MA组中,CysC、β2-MG 2指标的异常检出率明显高于Scr和Bun,差异有统计学意义(P<0.01)。结论:血清CysC检测在2型糖尿病肾脏损伤早期就开始异常并随着肾脏损害程度的加深而升高,说明血清CysC检测在2型糖尿病肾病早期诊断和了解肾脏损伤程度中有较高的临床意义。
Objective: To investigate the significance of cystatin C (CysC) in the diagnosis of type 2 diabetes mellitus (T2DM) kidney injury. Methods: A total of 175 T2DM patients were divided into three groups based on urinary albumin excretion rate (UAER): normal proteinuria group (UAER <30mg / 24h), 72 patients; microalbuminuria group (N = 58); clinical proteinuria (UAER> 300mg / 24h), 45 cases; another 60 healthy subjects were selected as the control group. Serum CysC levels were determined by immunoturbidimetry and serum creatinine (Scr), blood urea nitrogen (BUN), β2-microglobulin (β2-MG) and UAER were compared between groups. Results: The levels of 5 items in T2DM patients were significantly higher than those in the control group (P <0.01). The levels of CysC, β2-MG, UAER and Scr in the MA group were significantly different from those in the control group P <0.01 or P <0.05). The levels of CysC, β2-MG and UAER in NA group were significantly different from those in control group (P <0.05) UAER levels were significantly higher than the MA group and NA group, the difference was statistically significant (P <0.01). There was no significant difference in the abnormal detection rate of CysC, Scr, Bun and β2-MG 4 in NA group (P> 0.05), but the abnormal detection rate of CysC and β2-MG 2 in MA group was significantly Higher than Scr and Bun, the difference was statistically significant (P <0.01). Conclusions: Serum CysC is abnormal in the early stage of renal injury in type 2 diabetic patients and increases with the degree of renal damage, indicating that serum CysC detection has a high clinical significance in the early diagnosis and understanding of renal damage in type 2 diabetic nephropathy .