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目的探讨血清胱抑素C(Cys-c)联合尿微量白蛋白(m ALB)检测诊断糖尿病早期肾损伤的临床价值。方法选取2013年6月至2014年6月收治的68例糖尿病患者(尿常规检查提示尿蛋白定性阴性)为研究对象,选取同期体检科进行体检的50例健康人为对照组。分别采用乳胶增强免疫比浊法和颗粒增强免疫抑制比浊法测定Cys-c和m ALB,同时检测血尿素氮(BUN)和血肌酐(Scr)。比较两组患者Cys-c、m ALB、BUN和Scr差异及各指标检测的阳性率。结果研究组患者血清Cys-c[(2.1±0.6)mg/L vs(0.6±0.2)mg/L]和m ALB[(28.6±8.4)mg/L vs(3.2±1.4)mg/L]浓度明显高于对照组患者,差异均有统计学意义(均P<0.05);两组间血清BUN[(4.6±1.8)mmol/L vs(4.3±1.7)mmol/L]和Scr[(68.6±17.5)μmo/L vs(65.3±12.8)μmo/L]浓度无明显差异(均P>0.05)。研究组患者Cys-c和m ALB阳性率明显高于对照组患者(分别为33.8%vs 2.0%和30.9%vs 0.0%,均P<0.05);而两组间BUN和Scr阳性率无明显差异(分别为4.4%vs 4.0%和2.9%vs2.0%,均P>0.05)。结论联合检测血清胱抑素C和尿微量白蛋白能够明显提高糖尿病早期肾损伤的检出率,值得在临床中推广应用。
Objective To investigate the clinical value of serum cystatin C (cys-c) in combination with urinary microalbumin (m ALB) in the diagnosis of early diabetic nephropathy. Methods Sixty-eight patients with diabetes mellitus (urinalysis urinalysis qualitative negative) admitted from June 2013 to June 2014 were enrolled in this study. Fifty healthy subjects undergoing physical examinations in the same period were selected as control group. Cys-c and m ALB were detected by latex-enhanced turbidimetry and particle-enhanced immunosuppressive nephelometry. Blood urea nitrogen (BUN) and serum creatinine (Scr) were measured simultaneously. The differences of Cys-c, m ALB, BUN and Scr between the two groups and the positive rate of each index were compared. Results The serum concentrations of Cys-c [(2.1 ± 0.6) mg / L vs (0.6 ± 0.2) mg / L] and m ALB [(28.6 ± 8.4) mg / L vs (3.2 ± 1.4) mg / L] (4.6 ± 1.8) mmol / L vs (4.3 ± 1.7) mmol / L], and Scr [(68.6 ± 0.76) mmol / L) in the two groups were significantly higher than those in the control group (all P < 17.5) μmo / L vs (65.3 ± 12.8) μmo / L] (all P> 0.05). The positive rates of Cys-c and m ALB in the study group were significantly higher than those in the control group (33.8% vs 2.0% and 30.9% vs 0.0%, respectively, both P <0.05), while there was no significant difference in the positive rates of BUN and Scr between the two groups (4.4% vs 4.0% and 2.9% vs2.0% respectively, all P> 0.05). Conclusion Combined detection of serum cystatin C and urinary albumin can significantly improve the detection rate of early diabetic nephropathy, which is worth popularizing in clinic.