24 h尿微量白蛋白、血清胱抑素C水平与血清肌酐、尿素水平在2型糖尿病肾病早期诊断的意义

目的 探讨24 h尿微量白蛋白和血清胱抑素C水平以及血清肌酐、尿素水平在2型糖尿病肾病早期诊断中的意义。方法 选取2016年1月~2017年1月于我院住院的糖尿病肾病患者120例，按UAER分为三组:A组（UAER＜30 mg/24h）35例，B组（UAER 30~300 mg/24h）60例，C组（UAER＞300 mg/24h）25例，测定CysC、SCr、Urea的水平及阳性检出率，留取24 h尿液检测mAlb水平。结果 三组CysC、mAlb分别两两比较，其中B、C两组均高于A组，统计学意义显著（P＜0.01），C组高于B组，统计学意义显著（P＜0.01）。三组SCr、Urea分别两两比较，其中A组和B组相比，差异无统计学意义（P＞0.05），C组高于A、B两组，统计学意义显著（P＜0.01）。CysC在A、B、C三组中均有不同程度阳性检出率，根据UAER的升高而显著增加，CysC阳性检出率高于SCr、Urea的阳性检出率；SCr、Urea只有在B组和C组中有阳性检出率。结论 尿微量白蛋白和血清胱抑素C的检测可作为2型糖尿病肾病早期的监测和诊断指标，血清胱抑素C其敏感性显著高于血清肌酐、尿素。

The Significance of 24 h Urinary Microalbumin,Serum Cystatin C and Serum Creatinine and Urea Levels in the Early Diagnosis of Type 2 Diabetic Nephropathy

Abstract:Objective To investigate the significance of 24 h urinary microalbumin,serum cystatin C and serum creatinine and urea in the early diagnosis of type 2 diabetic nephropathy.Methods 120 patients with diabetic nephropathy hospitalized in our hospital in January 2016-January 2017 were divided into three groups according to UAER:A group(UAER<30 mg/24h)35 cases,B group(UAER 30~300mg/24h)60 cases,C group(UAER>300mg/24h)25 cases,the levels of CysC,SCr and Urea were detected,and the positive detection rate was determined.The mAlb level was determined by 24 h urine.Results Three groups of CysC and mAlb were compared one by one,and B and C group were higher than those of A group,with statistical significance(P<0.01).C group was higher than B group, with statistical significance(P<0.01).Three groups of SCr and Urea were compared,and there was no significant difference between A group and B group(P>0.05).C group was higher than A and B group,with significant statistical significance(P<0.01).CysC had positive detection rates in varying degrees in A,B,and C group,and increased significantly according to the increase of UAER.The detection rate of CysC was higher than that of SCr and Urea;SCr and Urea only had positive detection rates in groups B and C. Conclusion The detection of urinary microalbumin and serum cystatin C can be used as early monitoring and diagnostic indicators for type 2 diabetic nephropathy.The sensitivity of serum cystatin C is significantly higher than that of serum creatinine and urea.