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目的了解血清胱抑素C(Cys-C)、β_2-微球蛋白(β_2-MG)、同型半胱氨酸(Hcy)水平在糖尿病肾病(DN)患者中的诊断价值。方法 188例DN患者根据尿白蛋白/肌酐比率(ACR)进行分组:正常蛋白尿组(NA组)85例,微量蛋白尿组(MA组)54例,临床蛋白尿组(CA组)49例,另选择同期健康体检者50例作为对照组,比较各组血清Cys-C、β_2-MG、Hcy、血糖(GLU)、糖化血红蛋白(Hb A1c)、尿素(UREA)、肌酐(CREA)水平,并同时绘制受试者工作曲线(ROC),计算曲线下面积(AUC)以评估Cys-C、β_2-MG、Hcy在DN中诊断价值,并对各生化指标进行相关性分析。结果与对照组相比,血清Cys-C、β_2-MG、Hcy在NA组、MA组和CA组中表达明显升高,且随着DN进展而逐步升高。通过相关性分析,血清Cys-C、β_2-MG、Hcy与GLU、Hb A1c、UREA、CREA显著相关。通过ROC曲线分析,Cys-C、β_2-MG、Hcy及3项联合在DN中的曲线下面积(AUC)分别为0.885、0.761、0.739、0.934。结论糖尿病肾病患者血清Cys-C、β_2-MG、Hcy高表达,可用于DN的监测和早期诊断。
Objective To investigate the diagnostic value of serum Cys-C, β_2-MG and Hcy levels in patients with diabetic nephropathy (DN). Methods A total of 188 patients with DN were divided into two groups according to urinary albumin / creatinine ratio (ACR): 85 cases of normal proteinuria group (NA group), 54 cases of microalbuminuria group (MA group) and 49 cases of clinical proteinuria group (CA group) , And 50 healthy subjects were selected as the control group. The levels of serum Cys-C, β_2-MG, Hcy, GLU, Hb A1c, UREA and CREA were compared among groups. At the same time, the working curve (ROC) of the subjects was plotted, and the area under the curve (AUC) was calculated to evaluate the diagnostic value of Cys-C, β_2-MG and Hcy in DN, and the correlation analysis of each biochemical index. Results Compared with the control group, the levels of Cys-C, β_2-MG and Hcy in NA group, MA group and CA group were significantly increased, and gradually increased with the progression of DN. By correlation analysis, serum Cys-C, β_2-MG, Hcy and GLU, Hb A1c, UREA, CREA significant correlation. According to ROC curve analysis, the area under the curve (AUC) of Cys-C, β_2-MG, Hcy and three combinations in DN were 0.885, 0.761, 0.739 and 0.934, respectively. Conclusion Serum Cys-C, β_2-MG and Hcy are highly expressed in patients with diabetic nephropathy and can be used for the monitoring and early diagnosis of DN.