尿胱抑素C联合尿转铁蛋白与尿β2-微球蛋白联合尿微量白蛋白诊断早期糖尿病肾病价值

目的探讨尿胱抑素C(cystatin C,Cyst C)和尿转铁蛋白(transferrin,TRF)联合检测与尿β2-微球蛋白(β2-microglobulin,β2-MG)和尿微量白蛋白(microalbuminuria,mALB)联合检测诊断早期糖尿病肾病的临床价值。方法 238例2型糖尿病患者中mALB≤30mg/24h者118例为A组,mALB>30～220mg/24h者120例为B组;210例体检健康者为对照C组。采用ELISA法检测尿Cyst C,TRF,β2-MG,mALB,比较尿Cyst C和尿TRF联合检测与尿β2-MG和mALB联合检测对早期糖尿病肾病的诊断价值。结果经非参数检验分析,3组间差异均有统计学意义(P<0.01);尿Cyst C的AUC(0.645)<尿β2-MG AUC(0.794),尿TRF的AUC(0.783)>尿mALB的AUC(0.768);尿mALB和β2-MG二者联合检测阳性率60.9%高于尿CystC和TRF二者联合检测阳性率51.3%(P<0.01)。结论 2种联合检测方法对早期糖尿病肾病诊断均有价值。

Diagnostic value of the detection of urinary cystatin C and transferrin and the detection of urinary β2-microglobulin and microalbuminuria to early diabetic nephropathy

Objective To explore the clinical value of the combination detection of urinary cystatin C and transferrin,and the combination detection of urinary β2-microglobulin(β2-MG) and microalbuminuria(mALB) to the diagnosis of early diabetic nephropathy.Methods A total of 238 patients with type 2 diabetes mellitus were divided into 2 groups according to the level of 24-hour urinary albumin(UAlb),118 cases in group A(mALB<30 mg/24 h),and 120 cases in group B(mALB from 30 to 220 mg/24 h).Another 210 healthy subjects were as controls(group C).The levels of cystatin C,transferrin,β2-MG and mALB were respectively detected with ELISA technique to compare the diagnostic value of the detection of cystatin C and transferrin,and the detection of β2-MG and with mALB to the early diabetic nephropathy.Results The nonparametric analysis showed there was significant differences among the three groups(P<0.01).AUC of the cystatin C(0.645) was smaller than that of the β2-MG(0.794),and AUC of transfferrin(0.783) was larger than that of mALB(0.768).The positive rate of cystatin C combined with transfferrin(60.9%) was significantly higher than that of β2-MG combined with mALB(51.3%),which showed a significant difference(P<0.01).Conclusion Both of these two combination methods contribute to the diagnosis of early diabetic nephropathy.