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目的:研究糖尿病肾病(DN)患者血浆中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和血清胱抑素C(CysC)水平变化,分析其对DN的早期诊断价值。方法:选取160例糖尿病(DM)患者按尿微量白蛋白排泄率(UAER)分为DN前期组58例(A组),DN早期组52例(B组)及DN临床组50例(C组),同期选择健康体检者61例为对照组(D组)。比较四组受试者血中NGAL、CysC、尿素氮(BUN)和血肌酐(CREA),及尿中微量清蛋白(UMA)水平的差异,分析血NGAL、CysC与UMA之间的相关关系。结果:(1)A、B、C组受试者NGAL、CysC及UMA水平显著高于D组,且C>B>A,差异均有统计学意义(P<0.05);C组BUN和CREA水平均明显高于A、B、D三组,差异均有统计学意义(P<0.05),而A、B组较D组均无统计学差异(P>0.05)。(2)血NGAL、CysC与尿UMA均存在正相关关系(r=0.59,0.64;P均<0.05)。结论:DN早期患者血浆NGAL与血清CysC水平显著升高,且二者均与尿UMA水平存在正相关关系,可作为评价肾脏损害程度及DN早期诊断的较敏感的生物学标志物,临床推荐应用。
Objective: To investigate the changes of plasma neutrophil gelatinase-associated lipocalin (NGAL) and serum cystatin C (CysC) levels in patients with diabetic nephropathy (DN) and to analyze their early diagnostic value for DN. Methods: One hundred and sixty patients with diabetes mellitus (DM) were divided into two groups according to urinary albumin excretion rate (UAER): DN group (58 cases in group A), DN group in early stage (group B) and DN group (n = 50) ), 61 healthy subjects were selected as the control group (D group) in the same period. The levels of NGAL, CysC, BUN, CREA and UMA in the blood of the four groups were compared and the correlation between serum NGAL, CysC and UMA was analyzed. Results: (1) The levels of NGAL, CysC and UMA in group A, B and C were significantly higher than those in group D and C> B> A (P <0.05). The levels of BUN and CREA (P <0.05). There was no significant difference between group A and group B (P> 0.05). (2) There was a positive correlation between serum NGAL, CysC and urine UMA (r = 0.59,0.64; P <0.05). Conclusion: The plasma levels of NGAL and serum CysC in patients with early DN are significantly increased, and both are positively correlated with urinary UMA level, which may be used as a sensitive biomarker to evaluate the degree of renal damage and early diagnosis of DN. .