论文部分内容阅读
目的探究血清Hcy(同型半胱氨酸)、CysC(胱抑素C)与U-mALB(尿微量清蛋白)联合检测在早期诊断糖尿病肾病中的临床价值。方法抽取82例糖尿病患者,根据是否伴有肾损伤分为A组(伴有肾损伤)及B组(未伴有肾损伤),各41例,另选取同期健康体检者41例作对照组。以免疫透射比浊法检测CysC与U-mALB水平,以酶循环法检测血清Hcy含量。统计对比三组血清Hcy、CysC与U-mALB阳性率及表达水平,并分析各指标单独检测与联合检测DN敏感度与特异度。结果 B组血清Hcy、CysC与U-mALB阳性率(70.73%、78.05%、78.05%)高于对照组(0.00、0.00、2.44%),A组各指标阳性率(95.12%、100.00%、100.00%)高于B组,差异有统计学意义(P<0.05);B组血清Hcy、CysC与U-mALB水平高于对照组,A组各指标水平高于B组,差异均有统计学意义(P<0.05);血清Hcy、CysC与U-mALB联合诊断敏感度(92.68%)高于Hcy(68.29%)、CysC(75.61%)与U-mALB(73.17%),差异有统计学意义(P<0.05),联合诊断特异度(97.56%)与各指标单独诊断(100.00%、100.00%、97.56%)对比差异无统计学意义(P>0.05)。结论血清Hcy、CysC与U-mALB均为糖尿病早期肾损伤敏感指标,联合检测上述指标可有效提高糖尿病肾损伤早期诊断敏感度。
Objective To investigate the clinical value of serum Hcy (homocysteine), CysC (Cystatin C) and U-mALB (urine microalbumin) in the early diagnosis of diabetic nephropathy. Methods 82 patients with diabetes mellitus were divided into group A (with renal injury) and group B (without renal injury) according to whether there was renal injury, 41 cases each. Another 41 healthy subjects were selected as the control group. The levels of CysC and U-mALB were detected by immunoturbidimetry and serum Hcy levels were detected by enzymatic cycling method. The positive rates and expression levels of serum Hcy, CysC and U-mALB in three groups were compared statistically, and the sensitivity and specificity of each index alone and in combination with DN were analyzed. Results The positive rates of serum Hcy, CysC and U-mALB in group B were significantly higher than those in control group (70.73%, 78.05%, 78.05%, 95.12%, 100.00%, 100.00% %) Than in group B, the difference was statistically significant (P <0.05); the level of serum Hcy, CysC and U-mALB in group B was higher than that in control group, the level of each index in group A was higher than that in group B, the differences were statistically significant (P <0.05). The combined diagnostic sensitivity of serum Hcy, CysC and U-mALB was higher than that of Hcy (68.29%), CysC (75.61%) and U-mALB (P <0.05). There was no significant difference between the diagnostic specificity (97.56%) and each index alone (100.00%, 100.00%, 97.56%) (P> 0.05). Conclusions Serum Hcy, CysC and U-mALB are both sensitive indicators of early renal damage in diabetic patients. Combined detection of the above indexes can improve the early diagnosis sensitivity of diabetic renal injury.