血清胱抑素C测定在糖尿病肾病早期肾损伤中的检测价值

目的：检测血清半胱氨酸蛋白酶抑制剂C（胱抑素C，Cys—C）浓度，评价其对糖尿病肾病患者的早期诊断价值。方法：应用乳胶颗粒增强散射免疫比浊法（PENIA）测定88例糖尿病患者和30名健康体检者的血清Cys—C浓度，并同时测定血清肌酐（SCr）、β2-微球蛋白（β2-MG）、糖化血红蛋白A1c）HbA1c）、尿微量白蛋白（UMA）和尿肌酐（UCr），计算出内生肌酐清除率（CCr）。比较Cys-C与其他指标的相关性。结果：微量白蛋白尿组和临床白蛋白尿组的Cys—C、SCr、CCr、β2-MG、UMA均较正常白蛋白尿组和健康对照组有显著性差异；Pearson相关分析显示：糖尿病患者血Cys—C与SCr、β2-MG、UMA呈正相关，与CCr呈负相关。结论：Cys-C在评价糖尿病患者的肾功能状况时与SCr的相关性好且灵敏度高于Ccr、UMA和β2-MG等肾小球滤过率标志物。故Cys—C对糖尿病肾病早期诊断价值较其他指标更高。

Diagnostic value of serum cystain C mensuration in early renal impairment on diabetic nephropathy

Objective: To test the concentration of cystatin C(Cys-C) and evaluate the value in diagnosis of early diabetic nephropathy.Methods: The levels of serum Cys-C in 88 cases of diabetes and 30 healthy comparisons were determined by particle enhanced nephelometric immunoassay(PENIA).On the same time,SCr,β2-MG,UMA,glycosylated hemoglobinA1c(HbA1c) and urine creatinine(UCr) were measured in all patients.The Ccr was calculated,and Cys-C was compared with other indicators as well as the area under the ROC curve.Results: The levels of all of indicators in microalbuminuria group and clinical proteinuria group were much higher than those in normal proteinuria and healthy subjects;Cys-C and SCr,β2-MG,UMA were positively correlated,Cys-C and CCr were negative correlation.Conclusion: Cys-C and UMA have a good correlation and the sensitivity of Cys-C is higher than that of Ccr,SCr,β2-MG and other markers of glomerular filtration rate in the evaluation of renal function in patients with diabetes mellitus.The value of Cys-C for the diagnosis of diabetic nephropathy is higher than that of other indicators.