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目的分析血清同型半胱氨酸(Hcy)、胱抑素(Cys C)、糖化血红蛋白(HbA1C)及尿β2微球蛋白(β2-MG)水平的变化对糖尿病肾病的诊断价值,为临床诊断糖尿病肾病提供参考。方法选取平顶山市第一人民医院2013年3月—2016年5月收治的83例糖尿病肾病患者作为观察组,另选同期46例平顶山市第一人民医院健康体检者作为对照组,并以肾功能损伤程度为准将观察组患者分为轻度组(例数=41,20g/L≤微量白蛋白排泄率(UAER)<200g/L)和中重度组(例数=42,UAER≥200g/L),对比组间Hcy、Cys C、HbA1C及尿β2-MG水平变化,分析各指标与UAER的相关性。结果与对照组相比,观察组Hcy、Cys C、HbA1C及β2-MG水平显著提高,差异有统计学意义(P<0.05);中重度组Hcy、Cys C、HbA1C及β2-MG水平高于轻度组,差异有统计学意义(P<0.05);血清Hcy、Cys C、HbA1C、β2-MG水平均与UAER呈正相关性。结论血清Hcy、Cys C、HbA1C、β2-MG联合检测可作为诊断糖尿病肾病的参考指标,且能够反映肾功能的损伤程度,具有较高的实用价值。
Objective To evaluate the diagnostic value of serum homocysteine (Hcy), cystatin (Cys C), glycosylated hemoglobin (HbA1C) and urinary β2 microglobulin (β2-MG) in the diagnosis of diabetic nephropathy, Provide a reference for kidney disease. Methods 83 patients with diabetic nephropathy admitted to the First People’s Hospital of Pingdingshan City from March 2013 to May 2016 were selected as the observation group and 46 healthy subjects in the First People’s Hospital of Pingdingshan City during the same period were selected as the control group. The severity of injury was divided into mild group (the number of cases = 41, 20g / L≤ UAER≤200g / L) and the moderate-severe group (the number of cases = 42, UAER≥200g / L ), Hcy, Cys C, HbA1C and urinary β2-MG levels in the control group. The correlation between each index and UAER was analyzed. Results Compared with the control group, the levels of Hcy, Cys C, HbA1C and β2-MG in the observation group were significantly increased (P <0.05), while the levels of Hcy, Cys C, HbA1C and β2-MG in the moderate and severe groups were significantly higher than those in the control group Mild group, the difference was statistically significant (P <0.05); serum Hcy, Cys C, HbA1C, β2-MG levels were positively correlated with UAER. Conclusion The combined detection of serum Hcy, Cys C, HbA1C and β2-MG can be used as a reference index in the diagnosis of diabetic nephropathy, and can reflect the degree of renal damage, which has high practical value.