Objective To explore the diagnostic value of serum Cys C, hs - CRP,RBP and urine mALB, JMAG for early kidney functional injury in newly diagnosed type 2 diabetes mellitus ( T2DM ) patients. Methods Ninety newly diagnosed T2DM patients and 30 healthy volunteers were divided into group A, B , C, D respectively, with 5. 6 8.0% according to HbAIC. Serum Cys C, hs-CRP,RBP and urine JMAG, creatinine, mALB ( Simens plasma protein determinations ) and were detected by automatic chemistry analyzer, then comparative analysis of test results were made. Results The results of RBP and JMAG /Cr in group A , Cys - C, hs - CRP,RBP, mALB/Ci% JM AG/ Cr in group B, C were far higher than those in group D, especially higher in group C ; Moreover, there was 81 % positive rate of combined 5 markers in group C. Conclusion It is implied that early kidney injury occur when HbA1C≤6. 5% in newly diagnosed ( T2DM ) , and get severe with the increase of 11bAlC. Combined detection of serum Cys - C , hs - CRP, RBP and urine mALB and JMAG may have guiding significance of early diagnosis and predictions for kidney functional injury in T2DM patients, and CYS - C or RBP may be earlier indexes.%目的 探讨血清胱抑素C(Cys-C)、视黄醇结合蛋白(RBP)、超敏C反应蛋白(hs-CRP)和尿微量白蛋白(mALB)、N-乙酰-β-D氨基葡萄糖苷酶(NAG)对初诊2型糖尿病患者(T2DM)早期肾功能损伤的诊断价值.方法 选择90例初诊2型糖尿病(T2DM)患者(根据糖化血红蛋白HbA1C分为A、B、C 3组,5.6%8.0%)和30例健康志愿者(对照D组);采用全自动生化仪检测4组血清 hs-CRP、Cys-C、RBP和尿液肌酐(Cr)、NAG 及mALB (西门子特种蛋白仪)水平.结果 T2DM A组 RBP、Cys-C,B C两组血清hs-CRP、Cys-C、RBP 和尿mALB/Cr、NAG/Cr均高于D组,差异有统计学意义(P<0.05),以C组最为明显;C组81%的T2DM患者5项指标联合检测异常.结论 初诊T2DM患者HbA1c≤6.5% 即提示有早期肾功能损伤,随HbA1c增高而损伤加重.联合测定血Cys-C、RBP 、hs-CRP和尿mALB、NAG可能有助于从不同层面评判初诊T2DM早期肾功能损伤,Cys-C和RBP可能是较早期指标.
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