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目的探讨糖尿病(DM)患者血清中胱抑素C(CysC)、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)和尿微量清蛋白(U-mAlb)水平的联合检测对糖尿病肾病(DN)早期诊断的临床价值。方法采用免疫透射比浊法和比色法分别检测126例2型糖尿病(T2DM)患者(观察组)及80例健康体检者(对照组)血清CysC、Hcy、hs-CRP和U-mAlb含量,并对检测结果进行统计学分析。结果观察组血清CysC、Hcy、hs-CRP和U-mAlb水平均明显高于对照组,差异有统计学意义(P<0.01);CysC、Hcy、hs-CRP和U-mAlb单项指标检测对DM早期肾损害的阳性检出率分别为60.32%、75.40%、84.13%、63.49%,特异性为95%～100%,与对照组比较,差异有统计学意义(P<0.001);4项指标联合检测,敏感性可提高至96.83%,且敏感性和特异性之和最大。血清CysC与Hcy、hs-CRP和U-mAlb水平均呈显著正相关(r=0.952、0.971、0.926,P<0.01)。结论血清CysC、Hcy、hs-CRP和U-mAlb可作为DN早期诊断的敏感指标,联合检测更具实用价值。
Objective To investigate the combined detection of serum cystatin C (CysC), homocysteine (Hcy), hs-CRP and U-mAlb in patients with diabetes mellitus (DM) The clinical value of early diagnosis of diabetic nephropathy (DN). Methods The serum levels of CysC, Hcy, hs-CRP and U-mAlb in 126 patients with type 2 diabetes mellitus (T2DM) and 80 healthy controls (control group) were detected by immunoturbidimetry and colorimetric assay respectively. And the test results for statistical analysis. Results The serum levels of CysC, Hcy, hs-CRP and U-mAlb in the observation group were significantly higher than those in the control group (P <0.01). The levels of CysC, Hcy, hs-CRP and U- The positive rates of early renal damage were 60.32%, 75.40%, 84.13%, 63.49%, and 95% ~ 100%, respectively, which were significantly different from those of the control group (P <0.001) Joint detection, the sensitivity can be increased to 96.83%, and the sensitivity and specificity and the largest. Serum CysC was positively correlated with Hcy, hs-CRP and U-mAlb levels (r = 0.952,0.971,0.926, P <0.01). Conclusion Serum CysC, Hcy, hs-CRP and U-mAlb can be used as sensitive indicators of early diagnosis of DN, and the combined detection is more practical value.