血清Cys C和24h尿微量清蛋白定量联合检测对妊娠期糖尿病肾病的早期诊断价值

目的 探讨血清胱抑素C(Cys C)和24 h尿微量清蛋白定量联合检测在妊娠期糖尿病肾病(GDN)早期诊断中的应用价值。方法 选取110例孕37～40周妊娠期糖尿病患者为研究对象,根据肾小球滤过率(GFR)将其分为GFR中度下降30例为A组(30 ml/min/1.73m²≤GFR<60 ml/min/1.73m²),GFR轻度下降42例为B组(60 ml/min/1.73m²≤GFR<89 ml/min/1.73m²),GFR正常38例为C组(GFR≥90 ml/min/1.73 m²)。选取同期健康相同孕周孕妇40例作为对照D组。统计4组研究对象的血清Cys C和尿微量清蛋白、血尿素、血肌酐水平,进行统计分析。结果Cys C和尿微量清蛋白各组之间比较,差异均有统计学意义(F=31.21,34.70,P<均0.01)。血尿素和肌酐A组和其他各组比较,差异均有统计学意义(F=5.85,4.58,P均<0.01),血尿素和肌酐在B组、C组和D组之间比较,差异均无统计学意义(P>0.05)。A组和B组的血清Cys C与尿微量清蛋白间存在正相关关系(r=0.756,0.725,t=5.209,4.835,P均<0.01)。B组中Cys C的诊断敏感度为95.2%,24 h尿微量清蛋白的诊断敏感度为90.5%,两者联合检测的敏感度为100%(χ²=8.24,7.08,P均<0.05)。结论 血清Cys C和尿微量清蛋白作为妊娠糖尿病早期肾损害的敏感指标,联合检测对妊娠糖尿病肾病早期诊断及病情监测具有重要意义。

Diagnostic Value of Combined Measuring of Serum Cystatin C and 24 h Urine Microalbumin in Early Gestational Diabetes Kidney Disease

Objective To investigate the diagnostic value of serum Cystatin C and 24 h urine microalbumin quantitative examination in the early gestational diabetes kidney.Methods Chose 110 cases of patients from 37 to 40 weeks during pregnancy with gestational diabetes.According to the GFR,patients were divided into GFR moderate decline group A(30 ml/min/1.73m²≤GFR<60ml/min/1.73m²,n=30),GFR mild decline group B(60 ml/min/1.73m²≤GFR<89 ml/min/1.73m²,n=42)and GFR normal group C(GFR≥90 ml/min/1.73 m²,n=38).Choose the same gestational weeks 40 healthy pregnants cases as control group D.Statistics of four groups of serum Cys C,24 h urine microalbumin quantitative,serum urea and creatinine,then analize.Results The levels of serum cystatin C andurine microalbumin compared between each group respectively,the differences were statistically significant(F=31.209,34.698,P<0.01,respectively).Thelevels of blood urea and creatinine in group A when compared with the other groups,found that the difference was statistically significant(F=5.845,4.575,P<0.01,respectively).When comparing the levels of blood urea and creatinine among the groups B,C and D,there was no statistical difference of significance(P>0.05).There was positive correlation between levels serum Cys C andurine microalbumin in group A and B(r=0.756,0.725,t=5.209,4.835,P<0.01,respectively).The sensitivity of Cys C and urine microalbumin were 95.2% and 90.5%,sensitivity of the combination of Cys C and urine microalbuminwas 100%(χ²=8.24,7.08,P<0.05,respectively).ConclusionAs sensitive indicators of gestational diabetes in the early renaldamage stage,joint detection of Cys C and urine microalbumin is of great significance for diagnosis and monitoring of diabetes in the early renal damage stage.