血清胱抑素C评估肾功能在糖尿病病人中的临床应用价值

目的:评价血清胱抑素C(Cys-C)水平对于糖尿病病人肾功能不全的临床检测意义.方法:选取225例糖尿病病人,记录性别、年龄、病程、血压、身高及体质量,计算出体质量指数(BMI),使用肾动态显像法测定肾小球滤过率(GFR)(mL·min-1·1.73 m-2)值.所有病人分为3组:A组(GFR<60)、B组(60≤GFR<90)、C组(GFR≥90).检测血清胱抑素C(Cys-C)、血清视黄醇结合蛋白(RBP)、血肌酐(Scr)、血尿素(Sur)、血尿酸(UA)、24 h尿微量白蛋白(UmAlb).结果:3组病人年龄、病程、Scr、Sur、UA、RBP、Cys-C和UmAlb差异均有统计学意义(P<0.05);3组病人年龄、病程、Scr、Sur、UA、RBP、Cys-C、UmAlb与GFR均呈负相关关系(P<0.01);多元逐步回归显示Cys-C、年龄、UmAlb进入最佳方程,且血清Cys-C最先进入.结论:Cys-C、年龄、UmAlb是影响糖尿病病人GFR的主要因素,其中血清Cys-C是反映早期肾功能受损的一个更为理想、敏感的常规指标,有助于糖尿病肾脏疾病的早期防治.

The clinical application value of serum cystatin C in evaluating renal function in patients with diabetes mellitus

Objective:To evaluate the clinical significance of serum cystatin C(Cys-C) level in patients with diabetes mellitus complicated with renal disfunction.Methods:The gender,age,course of disease,blood pressure,height and quality of 225 patients with diabetes mellitus were recorded,the body mass index(BMI) was calculated,and glomerular filtration rate(GFR)(mL·min-1·1.73 m-2) was detected using Kidney dynamic imaging.All patients were divided into the group A(GFR<60),group B(60≤GFR<90) and group C(GFR≥90).The levels of serum Cys-C,serum retinol binding protein(RBP),serum creatinine(Scr),blood urea(Sur),blood uric acid(UA),24 hour urine microalbumin(UmAlb) in three groups were detected.Results:The differences of the age,course of disease,and the levels of Scr,Sur,UA,RBP,Cys-C and UmAlb between three groups were statistically significant(P<0.05).The age,course of disease,and the levels of Scr,Sur,UA,RBP,Cys-C and UmAlb were negative correlation with GFR in three groups(P<0.01).The multiple stepwise regression analysis showed that the Cys-C,age,umalb entered the best equation,and serum Cys-C was the first.Conclusions:The Cys-C,age,UmAlb are the main influencing factors of GFR in patients with diabetes mellitus.The serum Cys-C is more ideal and sensitive conventional index in reflecting the early renal disfunction,which can help the early prevention and treatment of diabetic renal disease.