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目的探讨血清胱抑素(CysC)在糖尿病肾病(DN)早期诊断中的意义。方法选取该院2015年1月—2016年1月该院就诊的2型尿病患者112例为观察组患者,按尿白蛋白排泄率(UAER)分为正常蛋白尿组(UAER<30 mg/24 h)37例、微量蛋白尿组(UAER 30~300 mg/24 h)38例和临床蛋白尿组(UAER>300 mg/24 h)37例,另外选取同期40名健康体检者作为对照组,采用乳胶颗粒增强免疫比浊法(PENIA)测定血清胱抑素C(CysC)、血肌酐(Scr)、尿素氮(BUN)水平,并且将4组患者的上述指标对比分析。结果血清CysC在糖尿病组均有明显升高,并且血清CysC水平随着病情的加重而逐渐增高,对照组的血清Cys C水平与正常蛋白尿组、微量蛋白尿组、临床蛋白尿组的血清Cys C水平比较,差异有统计学意义(P<0.05);临床蛋白尿组的BUN、Scr水平与健康对照组、正常蛋白尿组和微量蛋白尿组BUN、Scr水平比较,差异有统计学意义(P<0.05);BUN、Scr在正常蛋白尿组与微量蛋白尿组间的差异无统计学意义(P>0.05)。结论 Scr、BUN水平在糖尿病早期无明显变化,CysC在糖尿病肾病早期即出现明显变化,且CysC水平与病情的严重程度密切关联,其可以作为临床诊断早期糖尿病肾病的可靠指标,对诊断早期糖尿病肾病有重要的临床意义。
Objective To investigate the significance of serum cystatin (CysC) in the early diagnosis of diabetic nephropathy (DN). Methods One hundred and twelve patients with type 2 diabetes treated in our hospital from January 2015 to January 2016 were enrolled in this study. Patients were divided into normal albuminuria group (UAER <30 mg / (N = 37), 38 cases of microalbuminuria (UAER 30 ~ 300 mg / 24 h), and 37 cases of clinical proteinuria (UAER> 300 mg / 24 h). Forty healthy subjects were selected as the control group , Serum cystatin C (CysC), serum creatinine (Scr) and blood urea nitrogen (BUN) levels were measured by latex particle-enhanced immunoturbidimetry (PENIA), and the above indexes of four groups of patients were compared and analyzed. Results Serum CysC levels were significantly increased in diabetic group, and serum CysC levels gradually increased with the severity of the disease, the control group serum Cys C levels and normal proteinuria, microalbuminuria, clinical proteinuria serum Cys (P <0.05). The levels of BUN and Scr in clinical proteinuria group were significantly different from those in healthy control group, normal proteinuria group and microalbuminuria group (P <0.05) P <0.05). There was no significant difference in BUN and Scr between normal proteinuria group and microalbuminuria group (P> 0.05). Conclusions The levels of Scr and BUN have no obvious changes in the early stage of diabetes. The level of CysC changes significantly in the early stage of diabetic nephropathy, and the level of CysC is closely related to the severity of the disease. It can be used as a reliable index for clinical diagnosis of early diabetic nephropathy. Have important clinical significance.