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目的比较血清胱抑素C(Serum Cystatin C,CysC)与β2微球蛋白(β2-microglobulin,β2-MG)和尿微量白蛋白(microalbuinuria,m-Alb)等传统肾功能检测指标对于诊断早期糖尿病肾病(Diabetic Nephropathy,DN)的临床意义,探讨Cys C在早期糖尿病肾病患者中的诊断价值。方法选择60例早期2型糖尿病肾病患者(DN组),43例无肾病的2型糖尿病患者(Non-Diabetic Nephropathy,NDN组)和40例健康成年人(对照组),采用免疫比浊法测定血清CysC、β2-MG和晨尿中m-Alb的含量并分析比较三者对早期DN的诊断价值。结果早期DN组的血清CysC、β2-MG和晨尿中m-Alb的含量分别为(2.02±0.70)mg/L、(3.41±1.03)mg/L和(37.58±6.75)mg/L,显著高于NDN组和对照组(P<0.05);DN组的血清CysC、β2-MG和晨尿中m-Alb的及异常值检出率分别为76.67%、51.67%和73.33%,显著高于NDN组(P<0.05);三者诊断早期DN的灵敏度分别为93.33%、86.67%和92.33%,特异度分别为92.77%、78.31%和83.13%,诊断早期DN的ROC曲线下面积分别为0.934、0.889和0.919,血清CysC效果最优。结论血清CysC对早期DN的诊断较β2-MG和m-Alb更为敏感,有较好的临床应用价值。
Objective To compare the diagnostic value of traditional renal function tests such as Serum Cystatin C (CysC), β2-microglobulin (β2-microglobulin, and β-microglobulin) and microalbuminuria (m- To investigate the clinical significance of Cys C in early diabetic nephropathy. Methods Sixty patients with early type 2 diabetic nephropathy (DN group), 43 non-diabetic nephropathy (NDN group) and 40 healthy adults (control group) were enrolled in this study. Immunoturbidimetric assay Serum CysC, β2-MG and morning urine m-Alb content and analysis of three diagnostic value of early DN. Results The serum levels of CysC, β2-MG and morning urine m-Alb in early DN group were (2.02 ± 0.70) mg / L, (3.41 ± 1.03) mg / L and (37.58 ± 6.75) mg / L respectively (P <0.05). The detection rates of abnormal values of CysC, β2-MG and m-Alb in morning urine of DN group were 76.67%, 51.67% and 73.33% respectively, which were significantly higher than those of NDN group and control group NDN group (P <0.05). The sensitivity of three diagnosis of early DN was 93.33%, 86.67% and 92.33% respectively, the specificity was 92.77%, 78.31% and 83.13% respectively. The area under the ROC curve of early diagnosis DN was 0.934 , 0.889 and 0.919, the best serum CysC. Conclusion Serum CysC is more sensitive to early DN diagnosis than β2-MG and m-Alb, and has a good clinical value.