胱抑素C、D-二聚体和纤维蛋白原对早期糖尿病肾病的诊断价值

目的 分析胱抑素C(Cys-C)、D-二聚体(D-D)及纤维蛋白原(FIB)对早期糖尿病肾病的诊断价值.方法 选择2019年1月至2021年7月我院内分泌科就诊的1461例2型糖尿病患者作为研究对象,根据尿白蛋白/尿肌酐的比值(UACR)将其分为正常白蛋白尿(NA)组(UACR<30 mg/g,751例)、微量白蛋白尿...

Diagnostic value of cystatin C,D-dimer and fibrinogen in the diagnosis of early diabetic nephropathy

Objective To analyze the diagnostic value of cystatin C(Cys-C),D-dimer(D-D)and fibrinogen(FIB)in the diagnosis of early diabetic nephropathy.Methods A total of 1461 patients with type 2 diabetes were treated in the endocrinology department of our hospital from January 2019 to July 2021 were selected as the research objects.According to the urine albumin/creatinine ratio(UACR),the patients were divided into normal albuminuria(NA)group(UACR<30 mg/g,751 cases),microalbuminuria(MA)group(UACR 30-300 mg/g,365 cases)and clinical albuminuria(CP)group(UACR>300 mg/g,345 cases).The levels of Cys-C,D-D and FIB among the three groups and their correlation with UACR were compared,and ROC curve was used to analyze the diagnostic efficiency of Cys-C,D-D and FIB separate detection and three combined detection for early diabetic nephropathy.Results The levels of Cys-C,D-D and FIB in the NA group,the MA group and the CP group gradually increased with the aggravation of renal injury,and the differences were statistically significant(P<0.05).Cys-C,D-D,FIB and UACR were positively correlated(r=0.564,0.391,0.476,P<0.001).The combined detection of Cys-C,D-D and FIB has the highest diagnostic efficiency for early diabetic nephropathy(AUC=0.808,95%CI=0.785-0.830);among the single detection,the serum Cys-C was more effective in the diagnosis of early diabetic nephropathy(AUC=0.790,95%CI=0.767-0.813),followed by FIB and D-D.Conclusion Cys-C,FIB and D-D are positively correlated with UACR.The combination of the three indicators can be used as an important indicator for the diagnosis of early diabetic nephropathy.It has diagnostic value for monitoring the occurrence and development of the disease.