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目的探讨血清胱抑素C(Cys-C)、B型利钠肽(BNP)水平、尿微量白蛋白(UAlb)/肌酐(Cr)联合测定对糖尿病肾病(DN)的诊断价值。方法 2型糖尿病(T2DM)患者90例,根据内生肌酐清除率(Ccr)分为肾功能正常组(Ccr≥90ml/min)、肾功能轻度减退组(60ml/min≤Ccr<90ml/min)、肾功能重度减退组(Ccr<60ml/min),测定各组Cys-C、BNP、UAlb/Cr比值。并以30例健康体检者作为对照组。结果肾功能轻度减退组和肾功能重度减退组患者Cys-C、BNP及UAlb/Cr水平与肾功能正常组及对照组比较差异具有统计学意义。肾功能轻度减退组和肾功能重度减退组比较差异亦有统计学意义。Cys-C、BNP及UAlb/Cr比值水平均与血Cr水平成正相关。结论 Cys-C、BNP及UAlb/Cr比值在DN早期中明显升高,且与血Cr水平具有相关性。联合检测Cys-C、BNP及UAlb/Cr比值可成为DN的监测指标。
Objective To investigate the diagnostic value of combined detection of serum cystatin C (Cys-C), B-type natriuretic peptide (BNP) and urinary microalbuminuria (Cr) in patients with diabetic nephropathy (DN). Methods Ninety patients with type 2 diabetes mellitus (T2DM) were divided into three groups according to Ccr: normal renal function group (Ccr≥90ml / min), mild renal dysfunction group (60ml / min≤Ccr <90ml / min ), Severe renal dysfunction group (Ccr <60ml / min). The Cys-C, BNP and UAlb / Cr ratios of each group were determined. And 30 healthy people as a control group. Results The levels of Cys-C, BNP and UAlb / Cr in mild renal dysfunction group and severe renal dysfunction group were significantly different from those in normal renal function group and control group. There was also a significant difference between the mild renal dysfunction group and the severe renal dysfunction group. Cys-C, BNP and UAlb / Cr ratio levels were positively correlated with blood Cr level. Conclusion The Cys-C, BNP and UAlb / Cr ratios were significantly increased in early stage of DN and correlated with blood Cr level. Joint detection of Cys-C, BNP and UAlb / Cr ratio can be a monitoring indicator of DN.