老年糖尿病肾病患者血清糖化血红蛋白、IL-6、胱抑素C与肾小球滤过率的相关性分析

  目的  探讨老年糖尿病肾病患者血清糖化血红蛋白(HbA1c)、白介素(IL)-6以及胱抑素C(CysC)与肾小球滤过率(GFR)的相关性。  方法  选取永康市第一人民医院2020年1月—2021年6月收治的老年糖尿病肾病患者78例为观察组；同期收治的单纯老年糖尿病患者77例为对照组；同期接受健康体检并证实为健康者80名为健康组。分析3组研究对象HbA1c、IL-6、CysC及GFR，GFR采用肾动态显像法测定；比较观察组患者不同分期各指标水平；进一步分析HbA1c、IL-6、CysC与GFR的相关性。  结果  观察组患者HbA1c为(8.15±1.94)%，IL-6为(40.37±11.79)ng/L，CysC为(3.25±1.06)mg/L，GFR为(49.64±6.54)mL/min，对照组分别为(7.24±1.15)%、(14.22±6.98)ng/L、(1.52±0.55)mg/L、(103.21±4.85)mL/min，健康组分别为(5.16±0.33)%、(10.70±3.22)ng/L、(0.86±0.22)mg/L、(123.43±3.18)mL/min，观察组患者HbA1c、IL-6及CysC显著高于其他2组，对照组高于健康组，GFR显著低于其他2组，对照组低于健康组，差异均有统计学意义(均P < 0.05)；随着临床分期的增加，患者HbA1c、IL-6及CysC逐渐升高，GFR逐渐降低，组间比较差异均有统计学意义(均P < 0.05)；糖尿病肾病患者HbA1c、IL-6、CysC与GFR呈负相关关系(r=-0.537、-0.838、-0.709，均P < 0.05)。  结论  糖尿病肾病患者HbA1c、IL-6、CysC与GFR呈负相关，实际临床工作中可以通过测定HbA1c、IL-6、CysC水平评估患者病情。 

Correlation analysis of serum glycosylated haemoglobin,interleukin-6 and cystatin C with GFR in elderly patients with diabetic nephropathy

  Objective  To investigate the correlation of serum glycosylated haemoglobin (HbA1c), IL-6 and cystatin C (CysC) with the glomerular filtration rate (GFR) in elderly patients with diabetic nephropathy.  Methods  A total of 78 elderly patients with diabetic nephropathy who were treated in Yongkang First People's Hospital from January 2020 to June 2021 were selected as the observation group, and 77 elderly patients with simple diabetes who were treated in our hospital during the same period were selected as the control group. During the same period, 80 persons who underwent physical examination and were confirmed to be healthy were regarded as the healthy group. The levels of HbA1c, IL-6 and CysC and GFR were analysed in the three groups. GFR was determined by renal dynamic imaging method. The levels of various indexes in different stages of the observation group were compared. The correlation between the levels of HbA1c, IL-6 and CysC and GFR was further analysed.  Results  In the observation group, the HbA1c, IL-6, CysC and GFR were (8.15±1.94) %, (40.37±11.79) ng/L, (3.25±1.06) mg/L, (49.64±6.54) mL/min, respectively. In the control group, the HbA1c, IL-6, CysC and GFR were (7.24±1.15) %, (14.22±65.98) ng/L, (1.52±0.55) mg/L, (103.21±4.85) mL/min, respectively. In the healthy group, the HbA1c, IL-6, CysC and GFR were (5.16±0.33) %, (10.70±3.22) ng/L and (0.86±0.22) mg/L, (123.43±3.18) mL/min, respectively. The levels of HbA1c, IL-6 and CysC in the observation group were significantly higher than those in the other two groups. The levels of these indexes in the control group were higher than those in the healthy group (P < 0.05). The GFR in the observation group was significantly lower than those in the other two groups (P < 0.05). The GFR in the control group was lower than that in the healthy group (P < 0.05). With the increase of clinical stage, the levels of HbA1c, IL-6 and CysC gradually increased, and the GFR gradually decreased, and the differences between groups were statistically significant (all P < 0.05). The levels of HbA1c, IL-6 and CysC were negatively correlated with GFR levels in patients with diabetic nephropathy (r=-0.537, -0.838, -0.709, all P < 0.05).  Conclusion  The levels of HbA1c, IL-6 and CysC in patients with diabetic nephropathy are negatively correlated with the level of GFR. In clinical work, the levels of HbA1c, IL-6 and CysC can be measured to evaluate the patient's condition.