血清同型半胱氨酸、胱抑素C和尿足细胞检测在Ⅱ型糖尿病肾病的早期诊断中的作用分析  

Role and analysis of serum Hcy, Cys C and urinary podocyte detection in the early diagnosis of type Ⅱ diabetic nephropathy

作　　者：喻敏[1] 刘春雅[1] 罗林峰[1] 陈忆琳 YU Min;LIU Chun-ya;LUO Lin-feng;CHEN Yi-lin(Department of Nephrology,Qitzhou People's Hospital,Quzhou,Zhejiang 324000,China)

机构地区：[1]衢州市人民医院肾内科

出　　处：《中国卫生检验杂志》2019年第16期1984-1986,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的分析联合血清同型半胱氨酸(Hcy)、胱抑素C(Cys C)和尿足细胞检测在Ⅱ型糖尿病肾病(DN)诊断中的作用。方法选取2017年5月-2018年5月于本院就诊的145位Ⅱ型DM患者为研究对象,依尿白蛋白/肌酐比值将其分为正常白蛋白尿组42例(n=40)、微量白蛋白尿组(n=58)、大量白蛋白尿组(n=47);同时选取50例健康体检者为对照组。检测各组的Hcy、Cys C和尿足细胞的检测水平,并计算各指标的检测敏感性和特异性,并使用AOC曲线进行相关分析。结果对照组、正常白蛋白尿组、微量白蛋白尿组和大量白蛋白尿组的Hcy、Cys C水平和尿足细胞数差异有统计学意义(P均<0.05),并随着患者DN的进展而升高;联合检测的敏感性、特异性、阳性预测值显著高于单独Hcy、Cys C、尿足细胞的检测方法,差异有统计学意义(P均<0.05);单独血清Hcy、Cys C、尿足细胞数和联合检测诊断DN的最佳的切点分别为12.48μml/L、1.18 mg/L、0.88个/μl、84%,其曲线下的面积分别为0.72、0.78、0.76、0.92。结论血清Hcy、Cys C和尿足细胞检测在诊断Ⅱ型糖尿DN中具有较好的参考价值,值得在临床上进一步探讨使用。Objective To analyze the role of combined serum homocysteine(Hcy), cystatin C(Cys C) and urinary podocyte detection in the diagnosis of type 2 diabetic nephropathy(DN). Methods A total of 145 patients with type II DM who were admitted to our hospital from May 20, 2017 to May 20, 2018 were enrolled. The urinary albumin/creatinine ratio was divided into normal albuminuria group(n=40), microalbuminuria group(n=58), large albuminuria group(n=47);50 normal healthy subjects were selected as control group. The levels of Hcy, Cys C and urinary podocytes in each group were measured, and the detection sensitivity and specificity of each index were calculated, and correlation analysis was performed using the AOC curve. Results There was statistical significance on the differences in Hcy, Cys C levels and urinary podocytes among the control group, the normal albuminuria group, the microalbuminuria group and the large albuminuria group(P<0.05), and elevated with the progress of patient’s DN;sensitivity, specificity, and positive predictive value of combined used detection were significantly higher than Hcy, Cys C, and urinary podocytes alone, with the differences statistically significant(P<0.05);the serum Hcy, Cys C, urinary pod count alone and combined use of the best cut-off points for the detection of DN were 12.48 μmol/L, 1.18 mg/L, 0.88 cell/μL, 84%, and the areas under the curve were 0.72, 0.78, and 0.76 and 0.92, respectively. Conclusion Serum Hcy, Cys C and urinary podocyte detection have a good reference value in the diagnosis of type II diabetes DN, which is worthy of further clinical application.

关 键 词：糖尿病肾病 同型半胱氨酸 胱抑素C 足细胞 诊断 

分 类 号：R587.2[医药卫生—内分泌]