血清胱抑素C对糖尿病肾病临床分期的价值  

Clinical value of cystatin C in staging diabetic nephropathy

作　　者：袁心露[1] 崔世维[1] 朱晓晖[1] 王粹芳[1] 印彤[1] 顾云娟[1] 袁瑾[1] 

机构地区：[1]南通大学附属医院内分泌病科,226001

出　　处：《江苏医药》2010年第6期642-645,共4页Jiangsu Medical Journal

摘　　要：目的探讨胱抑素C(Cys-C)作为2型糖尿病(T2DM)肾病分期指标的应用价值。方法测定137例T2DM患者血肌酐(SCr)、Cys-C和24-h尿微量白蛋白排泄率(UAER)。运用MDRD公式计算肾小球滤过率(GFR)。将患者分为三组:GFR>120ml.min-1.1.73m-2为A组,GFR60～120ml.min-1.1.73m-2为B组,GFR<60ml.min-1.1.73m-2为C组。绘制散点图,比较三组Cys-C和UAER的数值及与GFR的相关性。结果C组SCr和24-hUAER高于A组[(102.41±10.72)μmol/Lvs.(42.73±3.99)μmol/L和(303.90±173.66)mgvs.(164.10±114.25)mg];A组Cys-C值明显低于B、C组[(0.47±0.21)mg/Lvs.(0.68±0.13)mg/L、(1.59±0.58)mg/L)]。UAER和Cys-C与GFR的相关系数分别为-0.132和-0.552(P<0.01)。ROC分析提示,Cys-C和UAER的曲线下面积(AUC)分别为0.885和0.605(P<0.05)。结论Cys-C能很好的反映T2DM肾病肾小球滤过功能异常,与临床分期的对应性、诊断特异性和灵敏性都优于UAER。Objective To evaluate the clinical usefulness of serum cystatin C（Cys-C）in staging diabetic nephropathy.Methods Serum creatinine（SCr）,Cys-C and urine albumin excretion rate（UAER） were detected in 137 patients with type 2 diabetes（T2DM）.Glomelular filtration rate（GFR） was calculated with MDRD-GFR fomula,based on which the patients were divided into three groups of A（120 ml·min-1·1.73 m-2）,B（60-120 ml·min-1·1.73 m-2） and C （60 ml·min-1·1.73 m-2）.Correlation between Cys-C and UAER with GFR was analyzed.Results Cys-C and UAER were significantly higher in group C than those in group A ／[（102.41±10.72） mol/L vs.（42.73±3.99） mol/L and （303.9±173.66） mg vs.（164.1±114.25） mg／].Cys-C was lower in group A than that in groups of B and C ／[（0.47±0.21） mg/L vs.（0.68±0.13） mg/L and （1.59±0.58） mg/L／].The correlation coefficient was-0.132 for UAER and GFR and-0.552 for Cys-C and UAER （P0.01）.Receiver operating characteristic curve（ROC） analysis showed the AUC of 0.885 for Cys-C and 0.605 for UAER.Conclusion The results indicate that Cys-C would be a good marker for the assessment of diabetic nephropathy in T2DM.

关 键 词：糖尿病肾病 肌酐 胱抑素C 尿微量白蛋白排泄率 

分 类 号：R587[医药卫生—内分泌]