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目的探讨血清胱抑素C(CystatinC,CysC)、同型半胱氨酸(Hemocysteine,Hcy)在2型糖尿病(type 2 diabetes,T2DM)肾损害早期诊断中的价值。方法检测血清CysC、Hcy、尿素(Blood-urea Nitrogen,BuN)、肌酐(Serum cre-atinine,Scr)、空腹血糖(Fasting Blood-Glucose,FBG)和糖化血红蛋白(Glycosylated Hemoglobin,HbAlc)的含量,同时检测尿微量白蛋白、尿肌酐并进行比较分析。结果 T2DM组CysC、Hcy水平显著高于对照组,差异有统计学意义(P<0.01);T2DM患者A组仅CysC、Hcy、FBG、HbAlc指标明显高于对照组(P<0.05,P<0.01);B组、C组各项指标均显著高于对照组(P<0.01);血CysC、Hcy、Scr对评价肾小球功能损伤灵敏度的比较,CysC、Hcy异常检出率均高于Scr,差异均有统计学意义(P<0.01)。结论 CysC、Hcy联合检测在DN早期有较高的检出率,比Scr有更高的敏感性,是反映DM患者早期肾损害的良好指标,可用于T2DM肾损害的进展检测和疗效观察。
Objective To investigate the value of serum cystatin C (CysC) and homocysteine (Hcy) in the early diagnosis of type 2 diabetes (T2DM) renal damage. Methods Serum levels of CysC, Hcy, blood urea nitrogen (BuN), serum creatinine (Scr), fasting blood glucose (FBG) and glycosylated hemoglobin (HbAlc) Urine microalbuminuria, urinary creatinine were measured and compared. Results The levels of CysC and Hcy in T2DM group were significantly higher than those in control group (P <0.01). Only the levels of CysC, Hcy, FBG and HbAlc in group A were significantly higher than those in control group (P <0.05, P <0.01) ). The indexes of group B and group C were significantly higher than those of control group (P <0.01). The sensitivity of evaluating the damage of glomerular function of CysC, Hcy and Scr was higher than that of Scr , The differences were statistically significant (P <0.01). Conclusion The combined detection of CysC and Hcy has a higher detection rate in early stage of DN and higher sensitivity than Scr. It is a good indicator of early renal damage in patients with DM, which can be used to detect the progression of renal damage in T2DM and observe the curative effect.