血清胱抑素C检测对糖尿病肾病早期诊断的价值

目的探讨血清胱抑素C检测对糖尿病肾病早期诊断的价值。方法选取2010年5月—2011年12月我院收治的2型糖尿病患者120例,根据尿微量白蛋白排泄率（UAE）分为两组：60例正常蛋白尿者为A组,60例微量蛋白尿者为B组,另选同期60例健康者为对照组,测定各组的血清胱抑素C（Cys-C）、肌酐（SCr）值,对结果进行独立样本t检验,比较Cys-C、SCr在各组中的异常检出率,分析A组Cys-C异常检出率与病程的关系,计数资料采用χ2检验。结果 A组、B组Cys-C、SCr值明显高于对照组,差异有统计学意义（P〈0.01）;两组Cys-C异常检出率比SCr检出率明显升高,A组分别为20%和3%;B组为41.7%和8.3%;且B组Cys-C异常检出率比A组明显升高,差异有统计学意义（P〈0.01）。在A组,病程5年以上者的Cys-C检出率明显高于病程3年以下者（P〈0.01）。结论 Cys-C是反映糖尿病早期肾功能损伤的敏感指标。在UAE正常阶段已存在早期肾功能受损,Cys-C在糖尿病肾病早期肾功能评估中优于SCr,且随着病程的进展检出率升高。

The Valuation of Serum Cystatin C in Early Diagnoses of Diabetic Nephropathy

OBJECTIVE To explore the valuation of serum cystatin c in early diagnoses of diabetic nephropathy.METHODS 120 cases of type 2 diabetic patients were divided into two groups by testing urinary albumin excretion（UAE）,60 cases UAE negative was named as Group A;60 cases UAE positive as Group B;and 60 cases healthy persons as the control group.The concentration of serum cystatin c and creatinine were determined in all groups.The results of diabetic groups were compared with the control group respectively.The detection rate of cystatin c compared with that of creatinine.RESULTS Serum cystatin c and creatinine concentrations in diabetic patients were significantly higher than those in the controls（P0.01）.In diabetic patients the detection rate of cystatin c was higher than that of creatinine.Group A：20% and 3%,Group B：41.7% and 8.3% respectively（P0.01）.And the detection rate of cystatin c of group B was higher than that of Group A（P0.01）.In Group A,patients of more than 5 years diabetic duration were compared with those less than 3 years diabetic duration,the cystatin c detection rate of the former was higher（P0.01）.CONCLUSIONS Serum cystatin c is a more sensitive marker to reveal the damage of glomerular filtration rate in early stage of diabetic nephropathy.