糖尿病肾病患者血清胱抑素C和β_2-微球蛋白及尿微量白蛋白/尿肌酐比值与尿蛋白的相关性  

Relationship of Urinary Protein Level with Serum Cystatin C, β_2-microglobulin and Urinary Albumin/creatinine Ratio in Patients with Diabetic Nephropathy

作　　者：周远青[1] 梁瑞莲[1] 谢健敏[1] 梁玉全[1] 刘建辉[1] 罗建伟[1] 

机构地区：[1]南方医科大学附属顺德第一人民医院检验科,广东省顺德528300

出　　处：《中国慢性病预防与控制》2012年第4期405-407,共3页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：广东省佛山市医学类科技攻关项目(200908162)

摘　　要：目的研究糖尿病肾病(DN)患者血清胱抑素C(CysC)、β2-微球蛋白(β2-MG)和尿微量白蛋白/尿肌酐比值(UmAlb/UCr)与尿蛋白程度的相关性,为DN的临床诊治提供依据。方法参照目前糖尿病合并DN公认的诊断指标,收集处于I期正常白蛋白尿期[24h尿微量白蛋白排泄率(UAE)<30mg/24h]、Ⅱ期微量白蛋白尿期(30mg/24h≤UAE<300mg/24h)和Ⅲ期大量白蛋白尿期(UAE>300mg/24h)的糖尿病患者各52例(A组),35例(B组)和21例(C组),健康对照组50例。检测研究对象血清CysC、β2-MG水平和UmAlb/UCr。结果与健康对照组比较,A组血清CysC、β2-MG水平升高,B、C组各检测指标均升高,差异均有统计学意义(P<0.01)。A、B、C组间比较,各检测指标差异均有统计学意义(P<0.01),且随着临床分期的发展,血清CysC、β2-MG水平和UmAlb/UCr均上升。血清CysC、β2-MG和UmAlb/UCr与UAE的Pearson相关系数分别为0.486,0.536和0.858,均有统计学意义(P<0.01)。结论糖尿病肾病患者血清CysC、β2-MG和UmAlb/UCr与蛋白尿分期密切相关,随着尿蛋白程度的发展,血清CysC、β2-MG水平和UmAlb/UCr均升高。Objective To study the relationship of urinary protein level with serum Cys C, β2-MG and urinary UmAlb/UCr ratio in patients with diabetic nephropathy（DN）. Methods The DN patients were divided into three phases according to 24-hour urinary albumin excretion rate（UAE） which recognized diagnostic indicator for diabetes mellitus complicated with DN, group A[n=52, in phaseⅠwith normoalbumin（UAE30 mg/24 h）], group B [n=35, in phase Ⅱ with microalbumin（30 mg/24 h≤UAE300 mg/24 h）] and group C[n=21, in phase Ⅲ with macroalbumin（UAE≥300 mg/24 h）]; 50 cases of healthy controls were collected. The levels of serum CysC, β2-MG and urinary UmAlb/UCr of all subjects were detected. Results Compared with the healthy control group, the levels of serum CysC, β2-MG of group A, group B and group C were significantly increased（P〈0.01）. Compared between three patient groups, the differences of all items were all significant between groups, and group Cgroup Bgroup A（P〈0.01）; the levels of serum CysC, β2-MG and urinary UmAlb/UCr increased with the increasing clinical phases and the correlation coefficients of serum CysC, β2-MG and urinary UmAlb/Ucr with the UAE were 0.486, 0.536 and 0.858, respectively（P〈0.01）. Conclusion The levels of serum CysC, β2-MG and urinary UmAlb/Ucr are closely related with the level of urinary protein in patients with diabetic nephropathy. As development of the degree of urinary protein, the level of serum CysC, β2-MG and urine UmAlb/UCr increase.

关 键 词：胱抑素C Β2-微球蛋白 尿微量白蛋白 糖尿病肾病 

分 类 号：R587.1[医药卫生—内分泌]