血清同型半胱氨酸与胱抑素C在2型糖尿病肾病患者中的变化意义分析

目的 在临床上对2型糖尿病合并肾病患者的血清同型半胱氨酸（Homocysteine,Hcy）水平和胱抑素C （Cystatin C,Cys C）水平进行测定,并探讨两指标在临床诊断中的价值.方法 回顾我院自选2011年6月至2013年6月间在我院进行治疗的184例糖尿病患者的病例.参照患者临床尿清白蛋白（UAER）水平分为糖尿病无肾病组（86例）和糖尿病合并肾病组（98例）,并选择90例健康体检者作为对照组.对三组的Hcy、Cys C和UAER的水平进行测定和对比分析.结果 糖尿病合并肾病患者的Hcy、Cys C和UAER水平分别为（22.48±2.42）μmol/L、（2.37±0.92） mg/L和（365.41±62.85） mg/24 h显著性的大于糖尿病无肾病患者（8.13±2.01）μmol/L、（1.01±0.62） rng/L和（36.47±10.26） mg/24 h和健康对照组（7.01±1.46）μmol/L、（0.91±0.59） mg/L和（29.41±8.58） mg/24 h,（P＜0.05）.而糖尿病无肾病患者的Hcy、Cys C和UAER水平略大于对照组患者,但两组间差异无统计学意义（P＞0.05）.多元线性分析结果表明：糖尿病合并肾病患者的Hcy、Cys C和UAER成正相关性（r=0.281、0.312,P＜ 0.05）.结论 Hcy和Cys C可作为临床诊断患者糖尿病状况的有效指标,联合使用能显著提升诊断的准确率.

Analysis on clinical significance of determining serum cystatin C and homocysteine level in type 2 diabetics associated with nephropathy

Objective To investigate the clinical value of determining serum cystatin C and homocysteine contents in patients with type 2 diabetes （DM2） complicated with nephropathy.Methods 184 cases of DM2 patients in our hospital from Jun 2011 to Jun 2013 were retrospectively analyzed.Based on the UAER level,patients were divided into diabetic with nephropathy group （98 cases） and diabetic without nephropathy group （86 cases）.And 90 cases of healthy people were selected as control group.Results The levels of serum cystatin C,homocysteine and urine protein in diabetic with nephropathy group were （22.48 ± 2.42） μ mol/L,（2.37 ± 0.92） mg/L,（365.41 ± 62.85） mg/24 h respectively,which were significantly higher than those of diabetic without nephropathy group （8.13 ± 2.01） μ mol/L,（1.01 ± 0.62） mg/L,（36.47 ± 10.26） mg/24 h] and control group （7.01 ± 1.46） μ mol/L,（0.91 ± 0.59） mg/L,（29.41 ± 8.58） mg/24 h],P ＜ 0.05.There was no significant difference in levels of serum cystatin C,homocysteine and urine protein between diabetic without nephropathy group and control group （P ＞ 0.05）.Multiple linear analysis results showed that the relationship among Hcy,Cys C and UAER was a positive correlation （r=0.281,0.312; P ＜ 0.05）.Conclusion The levels of serum cystatin C and homocysteine can be used as sensitive markers for early diagnosis of development of diabetic nephropathy.Their combined use can significantly increase the accurate rate of diagnosis.