血清胱抑素C及尿微量蛋白对糖尿病肾病早期损害的诊断价值

目的 探讨血清胱抑素C（Cys-C）及尿微量清蛋白（mAlb）、α1-微球蛋白（α1-MG）和β2-微球蛋白（β2-MG）水平检测对糖尿病肾病早期损害的诊断价值.方法 将2009年10月～2012年6月本院收治的糖尿病肾病早期损害患者72例作为观察组,同时将72例健康体检人群作为对照组,两组均采集空腹血用乳胶增强免疫比浊法检测Cys-C,取晨尿进行尿mAlb、α1-MG和β2-MG检测,观察两组的各项检测指标及检测阳性率.结果 观察组患者的Cys-C及尿中mAlb、01-MG和β2-MG水平显著高于对照组,差异有统计学意义（P＜0.05）;观察组患者的Cys-C检测阳性率为77.8％（56/72）,尿mAlb阳性率为68.0％ （49/72）,尿α1-MG阳性率为48.6％（35/72）,尿β2-MG阳性率为54.2％ （39/72）,四项指标联合检测的阳性率为90.3％（65/72）,显著高于各项指标单独检测的阳性率,差异有统计学意义（P＜0.05）.结论 Cys-C和尿微量蛋白各项水平可作为肾功能早期损害的标志物,且多项指标联合检测能够显著提高糖尿病肾功能早期损害的检出率,值得临床推广应用.

The diagnostic value of the serum cystatin C and urin trace protein on the damage in early diabetic nephropathy

Objective To investigate serum cystatin C ,urin of albumin （mAlb）,cq-microglobulin （α1-MG） and 62- microglobulin （β2-MG） level on the damage in early diabetic nephropathy.Methods 72 patients with early diabetic nephropathy were selected in our hospital from October 2009 to June 2012 as the observation group,while 72 healthy subjects were selected as the control group.Serum cystatin C of the two groups were examined by adoption of latex en- hanced turbidimetry and take morning urine to examine the mAlb,c~-MG and {~2-MG of the two groups.The detection of indicators and the positive rate of the two groups were observed.Results Serum cystatin C,mAlb,α1-MG and β2-MG of the observation group were significantly higher than that of the control group,there was statistical difference（P〈0.05）. The positive rate of Cys-C of the observation group was 77.8%（56/72）,the positive rate of mAlb was 68.1%（49/72）,the positive rate of α1-MG was 48.6%（35/72）,the positive rate of β2-MG was 54.2%（39/72）,the positive rate of the four markers was 90.3%（65/72）,the combined detection rate of the damage in early diabetic nephropathy was significantly higher than that of detection alone,there was statistical difference （P〈0.05）.Conclusion Serum cystatin C and various levels of the urine protein can be used as markers of early renal damage,but the combination of the many markers can significantly improve the detection rate of the damage in early diabetic nephropathy.It is worth to be popularized in clinical application.