摘要
目的探讨同型半胱氨酸、血清胱抑素C及尿微量白蛋白与尿肌酐比值对糖尿病肾病的诊断价值。方法选取150例2型糖尿病患者作为病例组,根据尿微量白蛋白不同分为单纯糖尿病组(42例)、早期糖尿病肾病组(尿微量白蛋白30~300 mg/24 h,40例)、中晚期糖尿病肾病组(尿微量白蛋白>300 mg/24 h,68例);另选取50例健康人群作为对照组。采用化学发光免疫分析法测定同型半胱氨酸水平;采用胶乳增强透射比浊法测定胱抑素C水平;采用免疫比浊法测定尿微量白蛋白水平;采用酶法测定尿肌酐水平,计算尿微量白蛋白与尿肌酐比值。比较四组同型半胱氨酸、胱抑素C水平及尿微量白蛋白与尿肌酐比值;比较同型半胱氨酸、胱抑素C、尿微量白蛋白与尿肌酐比值单独检测及联合检测对糖尿病肾病的阳性检出率、敏感度、特异度、准确度。结果对照组同型半胱氨酸、胱抑素C水平及尿微量白蛋白与尿肌酐比值分别为(8.02±1.05)μmol/L、(0.78±0.08)mg/L、(1.40±0.84)mg/g,单纯糖尿病组分别为(14.26±1.44)μmol/L、(2.70±0.66)mg/L、(47.80±8.18)mg/g,早期糖尿病肾病组分别为(19.24±2.20)μmol/L、(4.00±1.05)mg/L、(227.65±15.36)mg/g,中晚期糖尿病肾病组分别为(23.45±2.42)μmol/L、(6.58±1.74)mg/L、(345.30±18.83)mg/g。单纯糖尿病组、早期糖尿病肾病组、中晚期糖尿病肾病组同型半胱氨酸、胱抑素C及尿微量白蛋白与尿肌酐比值均高于对照组,差异有统计学意义(P<0.05);早期糖尿病肾病组、中晚期糖尿病肾病组同型半胱氨酸、胱抑素C及尿微量白蛋白与尿肌酐比值均高于单纯糖尿病组,差异有统计学意义(P<0.05);中晚期糖尿病肾病组同型半胱氨酸、胱抑素C及尿微量白蛋白与尿肌酐比值均高于早期糖尿病肾病组,差异有统计学意义(P<0.05)。联合检测对糖尿病肾病的阳性检出率为80.67%,明显高于同型半胱氨酸、胱抑素C及尿微量白蛋白�
Objective To discuss the diagnostic value of homocysteine,cystatin C and urinary microalbumin to creatinine ratio in diabetic nephropathy.Methods 150 patients with type 2 diabetes mellitus were selected as the case group and divided into simple diabetes mellitus group(42 cases),early diabetic nephropathy group(urinary microalbumin of 30-300 mg/24 h,40 cases),and advanced diabetic nephropathy group(urinary microalbumin>300 mg/24 h,68 cases)according to the difference of urinary microalbumin;another 50 healthy subjects were selected as the control group.Homocysteine levels were determined by chemiluminescence immunoassay;cystatin C levels were determined by latex-enhanced transmission turbidimetry;urinary microalbumin levels were measured by immunoturbidimetric assay;urinary creatinine levels were measured by enzymatic method,and the urinary microalbumin to creatinine ratio was calculated.Comparison was made on homocysteine,cystatin C levels and urinary microalbumin to creatinine ratio among the four groups;the positive detection rate,sensitivity,specificity and accuracy of homocysteine,cystatin C,urinary microalbumin to creatinine ratio alone and in combination for diabetic nephropathy.Results The levels of homocysteine and cystatin C and urinary microalbumin to creatinine ratio were(8.02±1.05)μmol/L,(0.78±0.08)mg/L and(1.40±0.84)mg/g in the control group,(14.26±1.44)μmol/L,(2.70±0.66)mg/L and(47.80±8.18)mg/g in simple diabetes mellitus group,(19.24±2.20)μmol/L,(4.00±1.05)mg/L and(227.65±15.36)mg/g in early diabetic nephropathy group,(23.45±2.42)μmol/L,(6.58±1.74)mg/L and(345.30±18.83)mg/g in advanced diabetic nephropathy group.The levels of homocysteine and cystatin C and urinary microalbumin to creatinine ratio of simple diabetes mellitus group,early diabetic nephropathy group and advanced diabetic nephropathy group were higher than those of the control group,and the differences were statistically significant(P<0.05).The levels of homocysteine and cystatin C and urinary microalbumin to creatinine
作者
吴丽梅
WU Li-mei(Department of Laboratory,Quangang District Hospital,Quanzhou 362801,China)
出处
《中国现代药物应用》
2023年第8期64-67,共4页
Chinese Journal of Modern Drug Application
