三项指标联合检测在糖尿病肾病早期诊断中的意义

目的探讨联合检测血清同型半胱氨酸（Hcy）、胱抑素c（CysC）、尿微量白蛋白（mALB）在糖尿病肾病早期诊断中的应用价值。方法分别检测单纯糖尿病组、早期糖尿病肾病组、临床糖尿病肾病组和正常对照组血清Cysc、Hcy和尿mALB含量。结果糖尿病各组的Hcy、CysC、尿mALB的水平及阳性率均显著高于对照组（P〈0．01），早期糖尿病肾病组三项指标水平显著高于单纯糖尿病组（P〈0．05），临床糖尿病肾病组三项指标水平显著高于早期糖尿病肾病组（P〈0．05）。三指标联合检测糖尿病肾病阳性率达96．25％，明显高于单项检测。结论血清Hcy、CysC和尿mALB是糖尿病肾病早期诊断的敏感指标，水平与肾脏损伤程度相关，三指标联合检测有助于糖尿病肾病的早期诊断。

Clinical significance of joint detection of three indicators on early diagnosis of diabetic nephropathy

Objective To investigate the value of joint detection of serum homocysteine（ Hcy）, cystatin C （Cys C） and urine microalbumin （mALB） on early diabetic nephropathy（DN） diagnosis. Methods The level of serum Cys C, Hcy and mALB were measured in simple diabetes mellitus group, early diabetic nephropathy group, clinical diabetic nephropathy group and 50 health controls. Results The level and positive rate of Hcy, Cys C, and mALB in diabetic group were significantly higher than those of controls（P 〈0.01 ）, the level of three indicators in early diabetic nephropathy group was significantly higher than those in simple diabetes mel- litus group （ P 〈 0. 05 ）, and those in clinical diabetic nephropathy group were significantly higher than those in early diabetic nephropathy group （ P 〈 0. 05 ）, the joint detection of those showed a positive rate of 96. 25% in diabetic nephropathy group which significantly higher than the individual detection. Conclusion Serum Hcy, Cys C and mALB are sensitive indicators on the early diagnosis of diabetic nephropathy, the level of these three indicators increased during the process of renal damage. The joint detection of them should be useful on the early diagnosis of diabetic nephropathy.