血清视黄醇结合蛋白、胱抑素C及β2微球蛋白的联合检测在妊娠期糖尿病早期肾损害诊断中的临床意义  

Clinical Significance of Combined Detection of Serum Retinal-binding Protein,Cystatin C and β2-micoglobuimin in Diagnosis of Early Renal Injures of Gestational Diabetes Mellitus

作　　者：袁学华[1] 张薇薇[2] 李权伦 柯盈月 王字卉 

机构地区：[1]十堰市妇幼保健院检验科,湖北十堰442000 [2]湖北医药学院附属人民医院感染性疾病科,湖北十堰442000

出　　处：《现代检验医学杂志》2017年第2期106-109,共4页Journal of Modern Laboratory Medicine

摘　　要：目的探讨血清视黄醇结合蛋白(RBP)、胱抑素C(Cys C)及β2微球蛋白(β2-M)联合检测在妊娠期糖尿病(GDM)早期肾损害的诊断价值。方法选取2009年1月~2015年1月在十堰市妇幼保健院患妊娠期糖尿病待产妇患者85例,根据其尿清蛋白排泄率(UAER)的测定结果被分为单纯糖尿病组(35例)、微量蛋白尿组(30例)和大量蛋白尿组(20例),选取同期来院待产的健康孕妇30例为正常对照组,比较4组间24 h尿蛋白量,血清RBP和肾功能指标[尿素氮(BUN),肌酐(Scr),Cys C和β2-M]水平,血清RBP,Cys C,β2-M单项及3项指标联合检测的阳性率。结果单纯糖尿病组,微量蛋白尿组及大量蛋白尿组的24 h尿蛋白量均明显高于对照组(t=3.91~16.33,均P<0.01),且3组间两两比较,差异均有统计学意义(t=6.78~16.94,均P<0.01);微量蛋白尿组和大量蛋白尿组的BUN,Scr,CysC,β2-M,RBP水平均明显高于对照组和单纯糖尿病组(t=3.68~18.54,均P<0.01),微量蛋白尿组与大量蛋白尿组间上述指标差异均有统计学意义(t=4.70~10.87,均P<0.01);微量蛋白尿组和大量蛋白尿组血清.RBP,Cys C,β2-M单项及3项指标联合检测阳性率明显高于对照组和单纯糖尿病组(x^2=20.27~38.57,均P<0.01),微量蛋白尿组与大量蛋白尿组间上述指标阳性率差异无统计学意义(x^2=0.62~0.93,均P>0.05);同组3项指标的联合检测阳性率高于单项检测的阳性率(x^2=3.97~6.65,P<0.05或P<0.01)。结论血清RBP,Cys C及β2-M的检测对妊娠期糖尿病早期肾损害诊断有较高的临床价值,3项指标联合检测的阳性率高于单项指标。Objective To study the diagnosis value of serum retinol binding protein （RBP） ,cystatin C（Cys C） and β2 micro globulin （β2-M） in early renal injures of gestational diabetes mellitus （GDM） patients. Methods 85 case of GDM pregnant women admitted to Shiyan Maternal and Child Health-Care Hospital from Jan. 2009 to Jan 2015 were chosen as research ob jects,and were divided into simple diabetes group （35 cases）, micro proteinuria group （30 cases） and massive proteinuria group （20 cases） according to the urinary albumin excretion rate （UAER） ,while 30 cases of healthy pregnant women were recruited randomly during the same period as control group. The 24b urine protein,serum RBP and renal function indicators [blood urea nitrogen （BUN）, ereatinine （Scr）, Cys C and β2-M], the positive rates of RBP, Cys C, β2-M and combined detec- tion of RBP,Cys C,132-M of the four groups were compared. Results The 24h urine protein in simple diabetes group,micro proteinuria group and massive proteinuria group were significantly higher than that in the control group （t= 3.91 ～ 16.33, all P-G0.01）, the difference between the .3 groups were statistically significant （t= 6.78 ～ 16.94, all P〈0.01 ）. The levels of BUN,Scr,Cys C, β2-M and RBP in micro proteinuria group and massive proteinuria group were significantly higher than those in control group and simple diabetic group （t= 3.68 ～ 18.54, all P-C0.01 ）, there were significant difference in above indexes between micro proteinurine group and massive proteinuria group （t= 4.70～ 10.87, all P〈0.01 ）. The positive rates of RBP,Cys C,β2-M and combined detection of RBP,Cys C and β2-M in micro proteinuria group and massive proteinuriagroup were significantly higher than those in control group and simple diabetic group （β2 = 20.27 ～ 38.57, all P〈0.01）. There was no significant difference in the positive rates between micro proteinuria group and massive proteinuria group （x^2 =0.62～0.93 ,all P）0.05）. The posi

关 键 词：视黄醇结合蛋白 半胱氨酸蛋白酶抑制剂C Β2微球蛋白 妊娠期糖尿病 早期肾脏损伤 

分 类 号：R714.256[医药卫生—妇产科学] R392.11[医药卫生—临床医学]