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目的探讨尿微量白蛋白/肌酐比值(U-mAlb/Cr)、血清胱抑素C(c)ys-C)和尿α1-微球蛋白(α1-MG)在糖尿病肾病(DN)早期诊断中的价值。方法观察组包含福建省立医院内分泌科2012年1月—2013年7月收治的2型糖尿病住院病人,其尿白蛋白排泄率在30~300 mg/d;对照组为该院健康体检者,收集二者血清及尿液标本,检测U-mAlb/Cr、Cys-C和尿α1-MG浓度进行比较。结果观察组U-mAlb/Cr、Cys-C和尿α1-MG检测结果与对照组比较均增高(P<0.05),而在UAER低水平增高时(UAER在30~100 mg/d),m-Alb/Cr(77.2%)和尿α1-MG(36.3%)阳性率与对照组相比均增高(P<0.05),Cys-C(9.09%)阳性率无显著性增高,将三者间阳性率作两两比较,差异有统计学意义。由此可推断,对UAER低水平增高的敏感性U-mAlb/Cr>尿α1-MG>Cys-C。结论 U-mAlb/Cr、Cys-C、尿α1-MG联合检测有助于糖尿病早期肾损害的诊断。
Objective To investigate the diagnostic value of urinary microalbumin / creatinine ratio (U-mAlb / Cr), serum cystatin C (c) ys-C and urinary α1-microglobulin (α1-MG) in the early diagnosis of diabetic nephropathy the value of. Methods The observation group included inpatients with type 2 diabetes admitted to Department of Endocrinology, Fujian Provincial Hospital from January 2012 to July 2013, whose urinary albumin excretion rate was 30 ~ 300 mg / d. The control group was healthy in the hospital, The serum and urine samples were collected and the concentrations of U-mAlb / Cr, Cys-C and urinary α1-MG were compared. Results The results of U-mAlb / Cr, Cys-C and urinary α1-MG in the observation group were significantly higher than those in the control group (P <0.05), while in the low UAER group (UAER ranged from 30 to 100 mg / d) The positive rates of -Alb / Cr (77.2%) and urinary α1-MG (36.3%) were significantly higher than those of the control group (P <0.05) and the positive rates of Cys-C The positive rate for each comparison, the difference was statistically significant. From this it can be inferred that the sensitivity U-mAlb / Cr> urinary α1-MG> Cys-C for the low UAER increase. Conclusion The combination of U-mAlb / Cr, Cys-C and urine α1-MG can be helpful for the diagnosis of early diabetic nephropathy.