同型半胱氨酸与胱抑素C在2型糖尿病肾病早期诊断中的应用价值

目的探讨同型半胱氨酸与胱抑素C在2型糖尿病肾病早期诊断中的应用价值。方法将110例疑诊2型糖尿病肾病的患者,根据24 h尿微量白蛋白排泄率的检查结果分为单纯糖尿病组（n=39）、糖尿病肾病早期组（n=38）和糖尿病肾病中晚期（n=33）,分别测定其肾小球滤过率（GFR）、血浆同型半胱氨酸、血清胱抑素C、血肌酐（Scr）、血尿素氮（BUN）等指标,对其中的相关性进行分析,并对同型半胱氨酸和胱抑素C作为糖尿病肾病早期诊断指标的真实性、可靠性和效益进行评价。结果 110例患者中同型半胱氨酸和胱抑素C水平与2型糖尿病患者的GFR、Scr和BUN有显著相关性（r=-0.746、0.902、0.745和-0.770、0.846、0.701,均P〈0.05）,半胱氨酸和胱抑素C作为糖尿病肾病早期诊断试验具有较高的真实性和可靠性（其灵敏度分别为87.32%、90.14%,特异度分别为94.82%、100.00%）。结论同型半胱氨酸与胱抑素C可以作为2型糖尿病肾病的早期诊断指标在临床上推广应用。

Diagnostic value of homocysteine and cystain C in type 2 diabetes patients with early stage of nephropathy

Objective To investigate the diagnostic value of homocysteine and cystain C in type 2 diabetes patients with early stage of nephropathy.Methods 110 cases with or without diabetic nephropathy were divided into three groups: diabete group(n=39),early diabetic nephropathy group(n=38) and end-stage nephropathy group(n=33).And the glomerular filtration rate,plasma homocysteine,serum cystain C,serum creatinine and blood urea nitrogen of the three groups were detected,and the relationships among the results above were analyzed.The authenticity,reliability and efficiency of homocysteine and cystain C in evaluating early stage of diabetic nephropathy in type 2 diabetes patients were evaluated.Results There were significant relationships among the levels of plasma homocysteine,serum cystain C and the glomerular filtration rate,serum creatinine,blood urea nitrogen in type 2 diabetes patients(r=-0.746,0.902,0.745 and-0.770,0.846,0.701).The levels of plasma homocysteine and serum cystain C had high authenticity and reliability in evaluating early stage of diabetic nephropathy(sensitivities were 87.32%,90.14% and specificities were 94.82%,100.00%).Conclusion It is suggested that homocysteine and cystain C can be used in clinical application as a new early diagnostic test.