尿白蛋白、血清胱抑素C在2型糖尿病合并亚甲减患者肾功能评价中的应用  

Application of Urinary Albumin and Serum Cystatin C in Evaluation of Renal Function in Patients with Type 2 Diabetes Mellitus Combined with Hypothyroidism

作　　者：唐洁[1] 薛冰蓉[1] 徐鹏[1] 高静[1] Tang Jie;Xue Bingrong;Xu Peng(Department of Clinical Laboratory Examination,Mianyang Central Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]绵阳市中心医院检验科,四川绵阳621000

出　　处：《四川医学》2018年第11期1274-1277,共4页Sichuan Medical Journal

摘　　要：目的探讨尿白蛋白(UALB)、血清胱抑素C(Cys C)和基于胱抑素C估算的肾小球滤过率(e GFR-CysC)对评价2型糖尿病合并亚甲减患者肾功能的价值。方法对符合纳入标准的30例2型糖尿病合并亚甲减患者(观察组)及同期63例单纯2型糖尿病患者(对照组)的甲状腺功能、尿素、肌酐、胱抑素C、糖化血红蛋白及晨尿白蛋白进行检测,比较两组各指标差异,分析指标对评价两组肾功能改变的价值。结果观察组患者的血清Cys C、UALB均高于对照组,而e GFR-CysC低于对照组(P<0. 05)。以GFR<90 m L/min/1. 73 m^2作为肾功能已轻度受损的判断标准,观察组UALB排泄量小于30 mg/L的患者中出现肾损伤的比例高于对照组(66. 67%vs 42. 11%,P<0. 05)。结论亚甲减可加重2型糖尿病肾损伤,单测UALB有可能引起漏诊,应联合应用UALB、Cys C和e GFR-CysC评价2型糖尿病合并亚甲减患者是否出现肾损伤。Objective To investigate the value of urinary albumin(UALB),serum cystatin C(CysC)and glomerular filtration rate based on cystatin C(eGFR-CysC)in the evaluation of renal function in patients with type2diabetes mellitus with subcutaneous hypothyroidism.Methods The thyroid function,urea,creatinine,cystatin C,glycosylated hemoglobin and morning urinary albumin of30patients with type2diabetes mellitus combined with hypothyroidism(observation group)and63patients with simple type2diabetes(control group)was tested and the differences between the two groups were compared.The value of the indicators was evaluated for the evaluation of renal function changes in the two groups.Results The serum CysC and UALB of the observation group were higher than those of the control group,while the eGFR-CysC was lower than the control group(P<0.05).When GFR<90mL/min/1.73m^2was used as the criterion for mild impairment of renal function,the proportion of renal injury in patients with UALB excretion less than30mg/L was higher in the observation group than in the control group(66.67%vs42.11%,P<0.05).Conclusion Hypothyroidism can aggravate renal damage in type2diabetic patients.Single-label UALB may cause missed diagnosis and UALB,CysC and eGFR-CysC should be combined used to evaluate whether type2diabetes mellitus combined with hypothyroidism has renal injury.

关 键 词：2型糖尿病 亚甲减 尿白蛋白 胱抑素C 肾小球滤过率 

分 类 号：R587[医药卫生—内分泌]