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目的探讨血清胱抑素C(Cys-C)、尿转铁蛋白(TRF)、血清超敏C-反应蛋白(hs-CRP)、尿α1-微球蛋白(α1-MG)等多种蛋白联合检测在糖尿病肾病诊断中临床价值。方法选取2015年7月-2016年5月本院诊治2型糖尿病患者160例为研究组,按照病理诊断结果将患者分为DM组和糖尿病肾病(DN)组,将DN组患者分为早、中、晚3期,以病理诊断为“金标准”判定联合检测对DN诊断灵敏度、特异度、诊断符合率;选取同期体检中心健康体检者50例为对照组,比较3组研究对象Cys-C、TRF、hs-CRP、α1-MG水平。结果 Cys-C、TRF、hs-CRP、α1-MG联合检测在DN组中诊断灵敏度为87.67%,特异度为87.36%,诊断符合率为87.50%。DN组患者Cys-C、TRF、hs-CRP、α1-MG水平均高于DM组和对照组,DM组患者Cys-C、TRF、hs-CRP、α1-MG水平均高于对照组,上述差异均有统计学意义(P<0.05)。DN早期组患者Cys-C、TRF、hs-CRP、α1-MG水平均低于中期组和晚期组患者(P<0.05)。结论 Cys-C、TRF、hs-CRP、α1-MG水平联合检测在DN诊断中具有较高灵敏度和特异性,能作为辅助鉴别诊断DM和DN及反映DN患者病情严重程度有效指标。
Objective To investigate the relationship between serum cystatin C (Cys-C), urinary transferrin (TRF), serum hs-CRP and α1-microglobulin Detection in the diagnosis of diabetic nephropathy in clinical value. Methods From July 2015 to May 2016, 160 patients with type 2 diabetes mellitus in our hospital were selected as study group. Patients were divided into DM group and diabetic nephropathy (DN) group according to the pathological diagnosis results. Patients in DN group were divided into two groups: Middle and late 3, the pathological diagnosis of “gold standard ” to determine the combined detection of DN diagnostic sensitivity, specificity, diagnostic coincidence rate; select the same period physical examination center health examination of 50 patients as control group, compared the three groups of study Cys -C, TRF, hs-CRP, α1-MG levels. Results The diagnostic sensitivity of Cys-C, TRF, hs-CRP and α1-MG in the DN group was 87.67%, specificity was 87.36%, and the diagnostic coincidence rate was 87.50%. The levels of Cys-C, TRF, hs-CRP and α1-MG in DN group were higher than those in DM group and control group. The levels of Cys-C, TRF, hs-CRP and α1-MG in DM group were higher than those in control group The differences were statistically significant (P <0.05). The levels of Cys-C, TRF, hs-CRP and α1-MG in patients with early DN were significantly lower than those in patients in intermediate and advanced stages (P <0.05). Conclusion The combined detection of Cys-C, TRF, hs-CRP and α1-MG has high sensitivity and specificity in the diagnosis of DN, and can be used as an effective index for assisting the differential diagnosis of DM and DN and reflecting the severity of DN patients.