联合检测 Cys-C HbA1c和 U-mAlb／Cr在2型糖尿病早期肾损伤诊断中的价值

摘要

Objective:To investigate the clinical application values of serum cystatin C ( Cys-C) , gly-cosylated hemoglobin (HbA1c) and urine microalbumin /creatinine (U-mAlb/Cr) in diagnosis of early kidney injury secondary to type 2 diabetes mellitus .Method:100 patients with type 2 diabetes mellitus were selected and divided into negative group ( 58 patients ) and positive group ( 42 patients ) according to the u-rine protein routine qualitative detection results .50 healthy people in the corresponding time period were en-rolled as control group .The Cys-C, HbA1c and U-mAlb/Cr were detected in the people of the three groups respectively.Result:The test results of Cys-C, HbA1c and U-mAlb/Cr in the negative group and positive group were higher than those of the control group , and the differences were statistically significant ( P<0. 05);and the test results of Cys-C, HbA1c and U-mAlb/Cr in the positive group were higher than those of the negative group, and the differences were statistically significant (P<0.05).The test results of Cys-C, HbA1c and U-mAlb/Cr in the control group were all in the normal limits; the detection rates of abnormal Cys-C, HbA1c and U-mAlb/Cr values ( detected both individually and in combination ) of the positive group were all higher than those of the negative group , and the differences were statistically significant ( P<0.05);the detection rate of abnormal Cys-C, HbA1c and U-mAlb/Cr value detected in combination was significantly higher than those detected individually , and the differences were statistically significant ( P<0. 05).The Cys-C and HbA1c results were positively-correlative with U-mAlb/Cr in the negative group.The areas under ROC curve of Cys-C, HbA1c and U-mAlb/Cr in the negative group were 0.906, 0.844 and 0. 896.Conclusion:Cys-C, HbA1c and U-mAlb/Cr levels are closely correlative with the early kidney injury degree in patients with type 2 diabetes mellitus;among them, Cys-C is the most sensitive , and a combined test of the three index can significantly elevate the positive rate .%目的：探讨血清胱抑素C（ Cys-C）、糖化血红蛋白（ HbA1c）、尿微量白蛋白与肌酐比值（ U-mAlb/Cr）在诊断2型糖尿病早期肾损伤中的临床应用价值。方法：选择2型糖尿病患者100例，根据尿蛋白常规定性检测结果分为阴性组（58例）和阳性组（42例），选择同期健康体检者50例作为对照组，分别检查Cys-C、HbA1c和U-mAlb/Cr。结果：阴性组及阳性组Cys-C、HbA1c及U-mAlb/Cr检测结果均高于对照组，差异有统计学意义（ P＜0．05），阳性组Cys-C、HbA1c及U-mAlb/Cr检测结果高于阴性组，差异有统计学意义（ P＜0．05）。对照组Cys-C、HbA1c及U-mAlb/Cr 检测结果均在正常范围；阳性组Cys-C、HbA1c、U-mAlb/Cr及三项指标联合异常检出率均高于阴性组，差异有统计学意义（ P＜0．05）；阴性组三项指标联合异常检出率明显高于各单项异常检出率，差异有统计学意义（ P＜0．05）。阴性组CysC、HbA1c与U-mAlb/Cr呈正相关（ P＜0．05）。阴性组Cys-C、HbA1c与U-mAlb/Cr的ROC曲线下的面积（ AUC）分别为0．906、0．844、0．896。结论：Cys-C、HbA1c和U-mAlb/Cr 的水平与2型糖尿病患者早期肾损伤程度密切相关，Cys-C最敏感，三项联合检测能显著提高检测阳性率。