血清胱抑素C浓度在Ⅱ型糖尿病肾病早期诊断中的临床价值

摘要

目的 探讨血清胱抑素C(Cys-C)浓度在Ⅱ型糖尿病肾病早期诊断中的临床价值,寻求肾小球滤过率的理想标志物.方法 根据尿白蛋白排泄率将92例糖尿病肾病早期患者分为:临床蛋白尿组(A组)、微量蛋白尿组(B组)和正常蛋白尿组(C组)3组,以30例健康体检者为对照组,采用乳胶颗粒散射比浊法检测Cys-C、酶法测定血肌酐(Scr)、尿肌酐(Ucr),尿素酶法测定尿素氮(BUN)和计算肌酐清除率(Ccr)等指标.结果 对照组Cys-C的浓度均低于A、B、C三组,差异均具有统计学意义(P<0.05),且Cys-C浓度随着病情加重逐渐升高;A组的Cys-C、Scr、BUN和Ccr分别与B、C两组比较,差异具有统计学意义(P<0.05).结论 血清Cys-C在糖尿病肾病早期检出较高,是反映肾小球滤过率的理想标志物,对糖尿病肾病早期诊断具有重要意义.%Objective To study the clinical significance of detecting serum level of Cystatin C in early diagnosis of diabetic nephropathy in patients with type Ⅱ diabetes, and to find out ideal markers for glomerular filtration rate. Methods According to the idea of Chung, urinary albumin excretion rate is important in classification, 92 patients with type Ⅱ diabetes are divided into 3 groups: clinical proteinuria group ( group A ),microalbuminuria group ( group B ) and negative albuminuria group ( group C ). Thirty healthy persons are selected as control group. Serum level of Cys - C is detected by latex particle enhanced immunoturbidimetric assay, and serum levels of Scr and Ucr are detected by enzymic method, and serum level of BUN is detected by urease - berthelot method. Their creatinine clearance rates ( Ccr ) are calculated and analyzed. Results Serum level of Cys C in diabetic nephropathy group is significantly higher than that of control group ( P ＜ 0.05 ). Serum levels of Cys C, Scr and BUN and Ccr in patients of group A are higher than those of patients in groups B and C ( P ＜ 0.05 ). Conclusion The detection rate of serum Cys C is high in early stage of diabetic nephropathy. Serum level of Cys C is an ideal serological marker for detecting early renal impairment in patients with diabetes.