2型糖尿病肾病患者血清Cys-C、ADPN、hs-CRP和HCY表达的临床意义

摘要

目的 探讨2型糖尿病肾病患者血清中胱抑素C(Cys-C)、脂联素(ADPN)、超敏C反应蛋白(hs-CRP)及同型半胱氨酸(HCY)的表达水平及临床意义.方法 选择2015年1月至2016年8月在该院就诊的120例2型糖尿病患者.按尿蛋白排泄量(UARE)分为单纯糖尿病组(UARE<30 mg/24 h)、微量蛋白尿组(UARE 30~300 mg/24 h)和临床蛋白尿组(UARE>300 mg/24 h);另外纳入 40例在该院进行体检的健康人群作为对照组.比较各组人群血清中Cys-C、ADPN、hs-CRP及HCY的表达水平,并进行相关性和诊断价值分析.结果 与对照组相比,糖尿病肾病患者的Cys-C、ADPN、hs-CRP及HCY都有不同程度上升,ADPN在对照组中表达偏高;相关分析显示,糖尿病肾病患者中Cys-C、hs-CRP及HCY均与UARE呈正相关;经ROC曲线分析显示,Cys-C敏感度、特异度较高,对糖尿病肾病有较好的诊断价值.结论 Cys-C在2 型糖尿病肾病具有较好的诊断意义;Cys-C、ADPN、hs-CRP及HCY在2型糖尿病肾病患者血清中异常表达,联合检测对早期诊断治疗和预后评估有重要的临床意义.%Objective To investigate the levels and clinical significance of Cystatin C (Cys-C),adiponectin (ADPN),hypersensitive c-reactive protein (hs-CRP) and homocysteine (HCY) in serum from type 2 diabetic nephropathy patients.Methods A total of 120 patients with type 2 diabetic nephropathy from January 2015 to August 2016 in our hospital were selected for the study.According to urinary albumin excretion rate (UARE),patients were divided into simple diabetic group (UARE<30 mg/24 h),microalbuminuria group (UARE 30-300 mg/24 h) and clinical albuminuria group (UARE>300 mg/24 h) and 40 healthy people were selected as control group.The levels of Cys-C,ADPN,hs-CRP and HCY in each group were compared and the correlation and diagnostic value were analyzed.Results Cys-C,hs-CRP and HCY in patients with type 2 diabetic nephropathy were significantly higher than that of control group (P<0.05).However,ADPN had a high level in control group.Correlation analysis showed there were positive correlation between Cys-C,hs-CRP,HCY and UARE.ROC curve showed that the sensibility and specificity of Cys-C were higher than other indicators,which had better diagnostic value on diabetic nephropathy.Conclusion Cys-C,ADPN,hs-CRP and HCY are aberrant expression in serum of patients with type 2 diabetic nephropathy.Cys-C has good diagnostic value in several indicators.