血清淀粉样蛋白A、胱抑素C与尿白蛋白/肌酐比值联合检测在早期糖尿病肾病中的诊断价值

摘要

Objective To investigate the combined determination of serum amyloid A protein(SAA), cystatin C(Cys C) and urinary albumin-to-creatinine ratio(ACR) in the diagnosis of early diabetic nephropathy (DN). Methods A total of 100 patients with type 2 diabetes mellitus(T2DM) and 100 patients with early DN were enrolled,and 50 healthy subjects were enrolled as healthy control group. The levels of serum SAA and Cys C and urinary ACR were determined. Pearson correlation analysis was performed,and receiver operating characteristic (ROC) curve was used. Results Serum SAA and Cys C levels and urinary ACR increased in turn in healthy control,T2DM and DN groups(P<0.05). Serum SAA and Cys C levels and urinary ACR in DN group were positively correlated(r=0.631 and 0.662,P<0.05). The area under ROC curve of the combined determination of serum SAA,Cys C and urinary ACR was bigger than those of the combined determinations of 2 items and single determinations. Conclusions The combined determination of serum SAA,Cys C and urinary ACR has higher accuracy than those of single determinations in the diagnosis of early DN.%目的 探讨血清淀粉样蛋白A(SAA)、血清胱抑素C(Cys C)和尿白蛋白/肌酐比值(ACR)联合检测在早期糖尿病肾病(DN)中的诊断价值.方法 选取临床明确诊断的单纯2型糖尿病(T2DM)患者100例、早期DN患者100例和体检健康者(正常对照组)50名,分别检测血清Cys C、SAA水平和晨尿ACR.各指标之间的相关性采用Pearson相关分析,采用受试者工作特征(ROC)曲线评价各项指标诊断DN的价值.结果 正常对照组、T2DM组和DN组血清Cys C、SAA水平和尿ACR依次升高,各组间比较差异均有统计学意义(P<0.05).DN组血清Cys C、SAA与尿ACR呈明显正相关(r值分别为0.631、0.662,P<0.05).ROC曲线分析显示,血清Cys C、SAA及尿ACR联合检测的曲线下面积(0.935)高于单项检测或2项联合检测.结论 在早期DN的诊断中,血清Cys C、SAA及尿ACR联合检测比单独检测ACR具有更高的准确性.