临床探讨血清同型半胱氨酸、胱抑素C在糖尿病肾病早期诊断中的作用分析

目的探讨糖尿病肾病患者血清中同型半胱氨酸和胱抑素C的变化和意义。方法选择健康体检者为对照组，根据24 h尿白蛋白排泄率（UAER）将糖尿病患者分为正常蛋白尿组、微量蛋白尿组和临床蛋白尿组，用荧光偏振免疫分析法和乳胶增强免疫比浊法，分别检测四组患者血清中同型半胱氨酸和胱抑素C的含量。结果正常蛋白尿组、微量蛋白尿组和临床蛋白尿组血清中同型半胱氨酸和胱抑素C的含量明显高于对照组（P〈0.05）,这三组患者血清中同型半胱氨酸和胱抑素C的含量也有明显差异，同型半胱氨酸与胱抑素C和UAER之间有明显的正相关（P〈 0.05）。结论同型半胱氨酸,胱抑素C在糖尿病肾病早期即明显升高，因此可作为糖尿病肾病早期诊断的指标,并在延缓糖尿病肾病的发生发展中有较高的应用价值和广泛的研究前景。

Analysis of the function of serum homocysteine and cystatin C on early diagnosis of diabetic nephropathy

Objective To explore the alterations and significations of concentration of serum homocysteine and cystatinC on early diagnosis of diabetic nephropathy. Methods Healthy subject served as normal controls, and the patientswith diabetic nephropathy who were involved in our experiment were divided into a group of patients with proteinuria,a group of patients with microalbuminuria, and a group of patients with clinical proteinuria according to their diumalUAER. So there were altogether four groups, counting the control group. Both fluorescent partial immune analysismethod and latex enhanced immune turbidimetry were used for detecting the concentration of serum homocysteine andcystatin C in the serum of patients in each of the four groups respectively. Results The concentration of serumhomocysteine and cystatin C in the serum of patients in each of the three groups was evidently greater than that of thesubjects belonging to the control group, as the difference can be indicated by P 〈 0.05. But between any two of thethree groups, the differences in concentration of serum homocysteine and cystatin C in patients’ serum varyconspicuously. Between UAER and serum homocysteine ＆ cystatin C, a positive correlation was markedly shown （P 〈0.05）. Conclusion Concentration of serum homocysteine and cystatin C in the serum of patients with diabeticnephropathy tends to rise manifestly at the inception of incidence of the disease. Therefore the said concentration canbe used in diagnosing the inceptive sign of the disease and not only rather effectively prevent the exacerbation of thedisease but probably open up a new vista for developing research in this connection.