血胱蛋白酶抑制剂C对糖尿病早期肾脏损害的诊断价值

目的:探讨血胱蛋白酶抑制剂C(Cystatin C、CC)在糖尿病患者早期肾脏损害中的诊断价值。方法:采用胶乳增强的散射免疫比浊法测定血CC和β2-微球蛋白(β2-MG),采用散射免疫比浊法测定尿微量白蛋白(mAlb)和α1-微球蛋白(α1-MG),并与健康对照组进行比较。结果:糖尿病组血CC、尿mAlb、α1-MG和β2-MG浓度比健康对照组显著增高(P<0.05);糖尿病患者血CC、尿mAlb、α1-MG和β2-MG升高的阳性率分别为48.1%、29.6%、38.9%和22.2%,血CC阳性率比尿mAlb、α1-MG和β2-MG显著升高(P<0.05);血CC与尿mAlb、α1-MG和β2-MG呈正相关。随着糖尿病病程的延长,尿α1-MG和β2-MG升高明显。结论:血CC是糖尿病早期肾脏损害的灵敏指标,联合尿mAlb、α1-MG和β2-MG的检测,对糖尿病肾病的早期诊断、肾功能损害程度及部位的判断具有一定的价值。

The Serum Cystafin C of Monitoring Early Renal Injury in Diabetes Patients

Objective: To study diagnostic value of serum Cystatin C (CC) for early renal injury in diabetes patients.Methods: The serum CC and the urinary β_2microglubin(β_2-MG) were detected by nephelometry immunoassay of latex enhance,and the urinary albumin(mAlb) and α_1-microglubin(α_1-MG) were detected by nephelometry immunoassay,and compared with healthy controls.Results: The levels of serum CC,urinary mAlb,α_1-MG and β_2-MG in diabetes patients were significantly higher than those in controls(P<0.05).The positive rates of serum CC,urinary mAlb,α_1-MG and β_2-MG in diabetes patients were 48.1%,29.6%,38.9% and 22.2% respectively.The serum CC were significantly higher than the urinary mAlb,α_1-MG and β_2-MG(P<0.05).A significant positive correlation was noted between serum CC and urinary mAlb,α_1-MG and β_2-MG.The levels of urinary α_1-MG and β_2-MG were increased gradually with the prolongation of patients condition.Conclusions: The serum CC is sensitive marker in diagnosis of early renal injury in diabetes patients.It is of value in detecting the degree of Renal injury in patients with diabetes nephropathy to measure urinary mAlb,α_1-MG and β_2-MG together.