血清胱抑素C测定对糖尿病肾病早期诊断的临床意义

目的研究血清胱抑素C在2型糖尿病肾病早期诊断中的临床应用。方法收集115例2型糖尿病患者，根据24小时尿白蛋白排泄量，将患者分为单纯性糖尿病组、早期DN组、临床DN组。比较三组患者血清胱抑素C、血肌酐、肾小球滤过率、肌酐清除率检测出。肾功能异常的比例并分析血清胱抑素c与肾小球滤过率的相关性；根据肾小球滤过率的数值，将单纯性糖尿病组的患者分为eGFR％60ml／min／1．73m^2和eGFR≥60ml／min／1．73m^2组，对两组间血清胱抑素C等各项指标进行比较，进行统计学分析。结果 1.血清胱抑素C与肌酐清除率检出肾功能异常的比例相当，但均明显高于血肌酐及尿素氮。2．在24小时尿白蛋白排泄量〈30mg的患者中，eGFR〈60ml／min／1．73m^2组患者的胱抑素C的水平明显高于eGFR≥60ml／min／1．73m^2的患者。结论血清胱抑素C与肾小球滤过率有很好的相关性，且在正常蛋白尿的糖尿病患者中即可以提示早期肾小球滤过率的下降。

Clinical significance of detection of Cystatin C in early diagnosis of diabetic nephropathy

Objective To explore the Clinical significance of detection of serum cystatin C in the early diagnosis of type 2 diabetic nephropathy. Methods A total of 115 patients with type 2 diabetes were enrolled for the analysis. Based on the different amounts of urine albumin excretion of 24 hours,all of the patients were divided into three groups：① simple diabetic group;②early DN group;③clinical DN group. Cystatin C, blood urea nitrogen, serum ereatinine and ser- um chemical parameters were measured, glomerular filtration rate and ereatinine clearance were calculated. The different parameters＇ detection rate of renal dysfunction at different levels of proteinuria were compared and the correlation be- tween Cys-c and glomerular filtration rate were analysed. The patients with normal albuminuria were divided into two groups according to eGFR. Serum cystatin C and other indicators were compared and analyzed statistically. Results The detection rate of both serum cystatin C and clearance of creatinine had no statistical difference （p〉0.05）, was higher than that of both serum creatinine and blood urea nitrogen（p〈0. 01）. Especially in the normal albuminuria group,the detection rate of clearance of creatinine and blood urine nitrogen were very low. Cystatin C and glomerular filtration rate had a good correlation,r=-0. 625. Conclusion The serum cystatin C and glomerular filtration rate have good correlation,and serum cystatin C can indicate an early decline in glomerular filtration rate in diabetic patients with normal proteinuria.