血清胱抑素C及其估算肾小球滤过率在早期糖尿病肾病诊断中的应用价值  

THE APPLICATION OF SERUM CYSTATIN C AND ESTIMATED GLOMERULAR FILTRATION RATES IN EARLY STAGE DIABETIC NEPHROPATHY DIAGNOSIS

作　　者：吴潇芸[1] 吴林秀[1] 刘春斌[1] 杨望荣[2] 

机构地区：[1]广西卫生职业技术学院,南宁530021 [2]广西中医药大学附属瑞康医院内分泌科,南宁530011

出　　处：《广西医科大学学报》2015年第6期924-927,共4页Journal of Guangxi Medical University

基　　金：广西高校科学技术研究课题资助项目(No.YB2014543)

摘　　要：目的:探讨血清胱抑素C(Cys-C)及[基于血清Cys-C估算肾小球滤过率(eGFR),(eGFR-Cys-C)]在早期糖尿病肾病(DN)诊断中的应用价值。方法:选择2013年8月至2014年7月在广西中医药大学附属瑞康医院内分泌科住院的2型糖尿病(T2DM)患者118例,根据其尿白蛋白排泄率(UAE)分为单纯T2DM组(T2DM组)及DN组,收集其空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c)、24h尿蛋白定量(24hUPQ)、血肌酐(Scr)、尿素氮(BUN)、血清Cys-C等生化指标及采用中国改良简化MDRD公式基于Scr估算eGFR(eGFR-MDRD),采用CHINA Cys方程eGFR-Cys-C并进行统计学分析。结果:血清Cys-C及eGFR-Cys-C与24hUPQ、BUN、Scr及eGFR-MDRD均有一定的相关性,各项指标ROC曲线下面积值均超过0.5,均可作为早期DN诊断的指标,其中24hUPQ、血清Cys-C及eGFR-Cys-C曲线下面积>0.7,其诊断效能均优于BUN、Scr及eGFR-MDRD,血清Cys-C诊断DN的界值为>0.95mg/L,eGFR-MDRD联合血清Cys-C诊断DN的灵敏度及特异度分别高达88.23%及96.53%,约登指数为0.848。结论:eGFR-MDRD、血清Cys-C两项指标联合诊断对早期DN的筛查效果好、真实性大,可望成为早期发现DN的一种有效、可行的办法。Objective： To explore the value of serum eystatin C（Cys-C） and estimated glomerular filtration rates（eGFR-Cys-C） in diagnosing early stage diabetic nephropathy. Methods： 118 patients with type 2 diabetes hospitalized from August 2013 to July 2014 were divided into two groups： Group A [simple type 2 diabetes （T2DM）] and Group B [diabetic nephropathy （DN）], according to their urinary albumin excretion rate. The fasting blood glucose （FBG）, 2 hour postprandial blood glucose （2 hPBG）, hemoglobin Ale （HbAlc）, 24 h urine protein quantitation （24 h UPQ）, serum creatinine （Scr）, blood urea nitrogen （BUN）, serum Cys-C and other biochemical indexes were collected in this study. We then estimated eGFR based on two equations, Ser （eGFR-MDRD） by equation MDRD and eGFR-Cys-C by equation CHINA Cys. Results：Serum Cys-C, eGFR-Cys-C, 24 h UPQ, BUN, Set and eGFR-MDRD can be used as diagnostic indicators for early stage DN, because the data of ROC curve were more than 0.5, of which 24 h UPQ, serum Cys-C and eGFR-Cys-C were more efficient than BUN, Scr and eGFR-MDRD of which the data of ROC curve were more than 0. 7. The critical value of serum Cys-C in the diagnosis of DN was DO. 95 rag/L, the sensitivity, specificity, Youden index of eGFR-MDRD combined with serum Cys-C in the diagnosis of DN were 88.23%, 96.53%, 0. 848. Conclusion： eGFR-MDRD combined with serum Cys-C can be effective in early diagnosis of DN.

关 键 词：糖尿病肾病 血清胱抑素C 估算肾小球滤过率 

分 类 号：R587.1[医药卫生—内分泌]