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目的探讨糖尿病肾病(diabetes nephropathy,DN)患者早期检测指标的应用价值。方法选取2012年7月—2013年10月收治的2型糖尿病(diabetes mellitus,DM)患者126例为DM组,根据24 h尿白蛋白排泄率(the 24 h urinary albumin excretion rate,UAER)将患者分为三组:SDM组33例、EDN组57例、CDN组36例,正常对照组(NC组)55例为同期来体检中心的健康体检者。定量检测CysC、Hcy、hs-CRP、U-mALB的浓度和阳性率,并将其结果与NC组进行比较。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 DM组CysC、Hcy、hs-CRP、U-mALB水平[(1.95±0.34)mg/L、(21.26±7.13)μmol/L、(5.31±2.25)、(352.67±113.58)mg/L]均明显高于对照组[(0.83±0.19)mg/L、(9.06±3.24)μmol/L、(0.85±0.23)、(10.53±4.11)mg/L],比较差异均有统计学意义(均P<0.05)。随着肾功能损伤的加重CysC、Hcy、hs-CRP、U-mALB水平均明显增加,差异均有统计学意义(均P<0.05)。患者CysC、Hcy、hs-CRP、U-mALB指标阳性率随DN的加重而增加,且联合检测阳性率均较单项指标检测高。结论联合检测糖尿病患者CysC、Hcy、hs-CRP、U-mALB可作为诊断DN早期肾损害的可靠敏感指标。
Objective To investigate the value of early detection of diabetic nephropathy (DN). Methods 126 patients with type 2 diabetes mellitus (DM) admitted from July 2012 to October 2013 were selected as DM group. According to the 24 h urinary albumin excretion rate (UAER) Divided into three groups: 33 cases in SDM group, 57 cases in EDN group, 36 cases in CDN group and 55 cases in control group (NC group) as healthy physical examination center in the same period. The concentrations and positive rates of CysC, Hcy, hs-CRP and U-mALB were detected quantitatively and compared with NC group. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The levels of CysC, Hcy, hs-CRP and U-mALB in DM group were significantly higher than those in DM group [(1.95 ± 0.34) mg / L, (21.26 ± 7.13) μmol / L, (5.31 ± 2.25), (352.67 ± 113.58) mg / L] (0.83 ± 0.19) mg / L, (9.06 ± 3.24) μmol / L, (0.85 ± 0.23) and (10.53 ± 4.11) mg / L respectively, all of which were significantly higher than those of the control group <0.05). The levels of CysC, Hcy, hs-CRP and U-mALB were significantly increased with the increase of renal dysfunction, the difference was statistically significant (all P <0.05). The positive rate of CysC, Hcy, hs-CRP and U-mALB increased with the increase of DN, and the positive rate of combined detection was higher than that of single index. Conclusions The combined detection of CysC, Hcy, hs-CRP and U-mALB in diabetic patients can be used as a reliable and sensitive index for diagnosis of early renal damage in DN.