多项生化检测指标对糖尿病肾病的早期诊断价值

目的：探讨糖尿病肾病血清胱抑素 C（CysC）、视黄醇结合蛋白（RBP）、β2-微球蛋白（β2-MG）以及尿液微清蛋白（mALB）、转铁蛋白（TRF）的变化对糖尿病肾病（DN）的早期临床诊断价值。方法根据尿蛋白排泄率（UAER）将确诊的118例糖尿病（DM）患者分为三组（单纯 DM 组，早期 DN 组，临床 DN 组），应用免疫比浊法检测血清 CysC、RBP、β2-MG 以及尿液β2-MG、TRF，同时用酶法检测血清肌酐（Cr），速率法检测尿素氮（Bun），并进行统计学处理。结果早期 DN 组、临床 DN 组 CysC、RBP、β2-MG 和尿液 mALB、TRF 水平明显高于单纯 DM 组，差异有统计学意义（P ＜0．05），而早期 DN 组 Cr 、Bun 水平较单纯DM 组略升高，差异无统计学意义（P ＞0．05），临床 DN 组 Cr 、Bu 明显高于单纯 DM 组，差异有统计学意义（P ＜0．05）。结论血清 CysC 、RBP、β2-MG 以及尿液 mALB 、TRF 水平在 DN 患者早期显著升高，对 DN 的早期诊断和监测有重要的临床价值。

Values of multiple biochemical indexes in diagnosis of early diabetic nephropathy

Objective To explore the diagnostic values of serum cystatin（CysC）,retinol binding protein（RBP）,β2 microglobulin （β2-MG）,and urine microalbumin（mALB）and transferrin（TRF ）in the diagnosis of early diabetic nephropathy（DN）.Methods 118 patients with diabetes mellitus（DM）were divided into three groups according to the urinary albumin excretion rate （UAER）, simple DM group,early DN group and clinical stage DN group.The immunity turbidimetry method was applied to measure the ser-um CysC,RBP,β2-MG and urine mALB,TRF;the enzymatic method was applied to measure the serum Cr;the rate method was applied to measure the serum Bun.The detection results were analyzed statistically.Results serum CysC,RBP,β2-MG and urine mALB,TRF levels in the early DN group and the clinical stage DN group were significantly higher then those in the simple DM group,the differences had statistical significance（P 〈0.05）,However,serum Cr and Bun levels in the early DN group were slightly higher than those in the simple DM group whithout statistically significant difference（P 〉0.05 ）,serum Cr and Bun levels in the clinical stage DN group were significantly higher than those in the simple DM group with statistical difference（P 〈0.05）.Conclu-sion Serum CysC,RBP,β2-MG and urine mALB,TRF levels in the patients with DN are significantly increased,which has the im-portant clinical value for early diagnosing and monitoring DN.