摘要
目的探讨血清胱抑素C(CysC)和尿α1-微球蛋白(α1-MG)在糖尿病肾病(DN)早期诊断中的价值。方法将524例2型糖尿病患者按尿微量清蛋白(mAlb)水平分为3组,mAlb正常组0～30mg/L,mAlb 31～100mg/L组和mAlb>100mg/L组。定量测定各组患者血清中CysC、肌酐(Cr)、尿素氮(BUN)、α1-MG的浓度。结果 mAlb正常组与健康对照组比较,BUN、Cr差异无统计学意义(P>0.05);3组糖尿病患者的血CysC和尿α1-MG水平较健康对照组均显著升高(P<0.05),并随着mAlb的上升而升高。血CysC和尿α1-MG的阳性检出率在3组糖尿病患者中均高于BUN和Cr(P<0.05)。血CysC和尿α1-MG联合检测,其阳性检出率在mAlb正常组中明显高于单项指标检出率,差异有统计学意义(P<0.05)。在肾功能早期病变(患者mAlb<100mg/L)的糖尿病患者中,各指标的阳性检出率由高到低为血CysC联合尿α1-MG>尿α1-MG>血CysC>BUN>Cr。结论血CysC和尿α1-MG对糖尿病肾病的早期诊断较Cr和BUN更有意义,联合检测血CysC和尿α1-MG可显著提高糖尿病早期肾损害的阳性检出率。
Objective The aim of the study was to investigate the diagnostic value of serum cystatin C（CysC） and urinary α1-microglobulin（α1-MG） in the early diabetic nephropathy.Methods The 524 type 2 diabetics in this study were divided into three different groups（mAlb normal group 0-30 mg/L,mAlb 31-100 mg/L和mAlb100 mg/L） according to their Urinary microglobulin（mAlb） value.Serum CysC,urinary α1-MG,BUN and Cr were measured in all individuals.Results By contrast to healthy control,the concentration of blood urea nitrogen（BUN） and creatinine（Cr） had not significantly increased in mAlb normal group（0-30 mg/L）（P0.05）.However,the levels of serum CysC and urinary α1-MG significantly increased in three different groups of diabetics compared with healthy control（P0.05）,and in a mAlb concentration dependent manner.The positive rates of serum CysC and urinary α1-MG were higher than those of BUN and Cr in three different groups of diabetics（P0.05）.Combined measure of serum CysC and urinary α1-MG remarkably increased the positive rate in mAlb normal group（0-30 mg/L）,and the result was better than serum CysC or urinary α1-MG alone（P0.05）.The positive rate sequence of 4 testing items in diabetics groups with early impairment of renal function（mAlb 0-30 mg/L and mAlb 31-100 mg/L） was serum CysC ＋ urinary α1-MG urinary α1-MG serum CysC BUNCr.Conclusion Serum CysC and urinary α1-MG are more efficacious than serum BUN and Cr in early diagnosis of diabetic nephropathy,and combined test of serum CysC and urinary α1-MG can significantly increase the positive rate of early renal impairment in diabetic patients.
出处
《检验医学与临床》
CAS
2013年第1期57-59,共3页
Laboratory Medicine and Clinic
关键词
胱抑素C
尿Α1-微球蛋白
肌酐
尿素氮
糖尿病肾病
cystatin C
urinary 1-microglobulin
blood urea nitrogen
creatinine
diabetic nephropathy
