半胱氨酸蛋白酶抑制剂C在2型糖尿病肾病早期诊断中的应用

目的 比较半胱氨酸蛋白酶抑制剂C（Cystatin C）、血肌酐（Scr）和肌酐清除率（CCr）在2型糖尿病肾病早期诊断中的价值。方法 将62例2型糖尿病患者按尿白蛋白排泄率（UAE）分为3组，A组为正常蛋白尿患者20例（UAE＜20μg／min），B组为微量蛋白尿患者23例（UAE20～200／μg／min），C组为大量蛋白尿患者19例（UAE〉200μg／min）。测定各组血肌酐及CystatinC，并计算肌酐清除率。同时检测尿CystatinC和CCl-微球蛋白（a1-M），并按尿a1-M间的浓度分为阴性组、微量组和阳性组。结果 血CystatinC和CCr在各组间的差异有显著性（P〈0．05），而Scr在A组和B组间的差异无显差著性，而C组的Scr高于A、B组，差异有显著性（P〈0．05）。尿Cystatin C值在各组病例间的差异均有显著性（P〈O．01）。结论 Cystatin C是临床上诊断早期糖尿病肾病的敏感指标之一。

Evaluation of Cystatin C in the Early Diagnosis of Diabetic Nephropathy in Type 2 Diabetes

Objective To explore the value of serum and urine cystatin C,serum creatinine （Scr） and creatinine clearance rate （CCr） in the early diagnosis of type 2 diabetic nephropathy. Methods Sixty-two type 2 diabetic patients were divided into normal albumiuria group, microalbumiuria group and macroalbumiuria group according to urine albumin excretion rate （UAE）. Cystatin C was determined by particle-enhanced immunoturbidimetry. Creatinine clearance rate （CCr） were estimated by formula. Urine cystatin C and al-microglobulin were detected simultaneously and were divide into negative group, micro-group, and positive group respectively, according to urine al-Microglobulin. Results Serum Cystatin C and CCr were different among the three groups （P〈0. 05） ,but Scr was not different between normal albumiuria group and mieroalbumiuria group （P〈0.05）. The value of urine cystatin C were different among those groups （P〈0. 01）. Conclusion Cystatin C is a sensitive parameter superior to Scr and CCr in diagnosing early diabetic nephropathy.