血清半胱氨酸蛋白酶抑制剂C在糖尿病肾病早期诊断中的应用价值

目的：探讨检测血清半胱氨酸蛋白酶抑制剂C（Cystatin C）在早期诊断糖尿病肾病（DN）中的应用价值。方法：健康体检者20例,糖尿病患者76例,用乳胶颗粒增强比浊法检测血清Cystatin C浓度,用全自动生化分析仪检测血尿素（Urea）、血清肌酐（Scr）浓度。根据肌酐清除率（Ccr）分成4组。结果：在Ccr≥70mL.min-1组中,Urea和Scr值均在正常范围内,Cys-tatin C异常率29%;在Ccr70~51mL.min-1组中,Cystatin C异常率73%,Scr异常率20%,Urea无异常;在Ccr50~31mL.min-1组中,Cystatin C异常率91%,Scr异常率36%,Urea异常率27%;在Ccr≤30mL.min-1组中,Cystatin C异常率100%,Scr异常率100%,Urea异常率87%。Ccr与Urea、Scr和Cystatin C呈负相关,Cystatin C与Urea和Scr呈正相关。结论：Cystatin C能敏感地反映早期肾功能损害,在糖尿病肾病的早期诊断和监控中具有应用价值。

The Application of Cystatin C in the Early Diagnosis of Diabetic Nephropathy

Objective：To study the application value of serum cystatin C for the diagnosis of diabetic nephropathy（DN） in earlier period.Methods： In 20 health medical examination peoples and 76 diabetes mellitus（DM） patients,serum cystatin C concentration was detected using latex particle enhanced turbidimetry.Urea and serum creatinine（Scr）were detected simultaneously using automatic biochemistry analyzer.The DM patients were divided into 4 groups according to the concentration of Ccr.Results： In the group with Ccr more than 70 mL/min-1,the levels of Urea and Scr were all normal,the excrescent rate of Cystatin C was 29%;In the group with Ccr 51-70 mL/min-1,the abnormal rate of Cystatin C was 73%,while the abnormal rate of Scr was 20%;In the group with 31 mL/min-1≤Ccr≤50 mL/min-1,the abnormal rate of Cystatin C was 91%,while the abnormal rate of Scr was 36%,the abnormal rate of Urea was 27%;In the group with Ccr less than 30 mL·min-1,the excrescent rate of Cystatin C was 100%,the abnormal rate Scr was 100%,the abnormal of Urea was 87%.Cystatin C was positively correlated with Urea,Scr.Conclusions： Cystatin C can reflect early kidney injury sensitively,which is valuable in the diagnosis and monitoring of diabetic nephropathy（DN） in earlier period.