血清CysC、RBP和尿NAG、GAL检测对早期糖尿病肾病的诊断价值  

The diagnostic value of serum CysC,RBP,urine NAG and GAL in patients with early diabetic nephropathy

作　　者：张俊平 李峰 刘伟杰 王娜 高爽 ZHANG Junping;LI Feng;LIU Weijie;WANG Na;GAO Shuang(Department of Clinical Laboratory,Rongcheng County People′s Hospital,Baoding,Hebei 071700,China)

机构地区：[1]河北省保定市容城县人民医院检验科

出　　处：《检验医学与临床》2020年第5期640-642,646,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨血清半胱氨酸蛋白酶抑制剂C(Cys-C)、视黄醇结合蛋白(RBP),以及尿N-乙酰-β-D氨基葡萄糖苷酶(NAG)、β-D半乳糖苷酶(GAL)检测对早期糖尿病肾病的诊断价值。方法选取2017年9月至2018年9月该院收治的132例糖尿病肾病患者为研究对象,根据患者尿清蛋白定量水平分为3组,观察组1(44例)为正常尿清蛋白,观察组2(44例)为微量尿清蛋白,观察组3(44例)为大量尿清蛋白;另选44例同期健康体检者为对照组。比较各组Cys-C、RBP、NAG及GAL水平;计算各指标单独及联合检测诊断糖尿病肾病的诊断符合率。结果对照组Cys-C、RBP、NAG及GAL水平均低于观察组1、2、3(P<0.05);观察组1 Cys-C、RBP、NAG及GAL水平均低于观察组2、3(P<0.05);观察组2 Cys-C、RBP、NAG及GAL水平均低于观察组3(P<0.05)。各观察组Cys-C、RBP、NAG及GAL 4项联合检测的诊断符合率高于各指标单独检测;观察组3各指标单独及联合检测的诊断符合率均高于观察组1、2(P<0.05);观察组2各指标单独及联合检测的诊断符合率均高于观察组1(P<0.05)。结论糖尿病患者Cys-C、RBP、NAG及GAL水平随着尿清蛋白定量的增加逐渐升高,且各指标单独及联合检测诊断糖尿病肾病的符合率也随肾功能损伤程度增加而逐渐升高。Objective To investigate the diagnostic value of serum cystatin C(Cys-C),retinol binding protein(RBP),urine N-acetyl-β-D glucosidase(NAG),β-D galactosidase(GAL)in early diabetic nephropathy.Methods A total of 132 diabetic nephropathy patients admitted to the hospital from September 2017 to September 2018 were selected as the research cases.The patients were divided into 3 groups according to the levels of urine albumin,the observation group 1(n=44)was normal urine albumin,the observation group 2(n=44)was microalbumin,and the observation group 3(n=44)was a large amount of urine albumin;another 44 healthy cases at the same period were selected as the control group.The levels of Cys-C,RBP,NAG and GAL in each group were compared,and the diagnostic coincidence rate of each index was calculated.Results The levels of Cys-C,RBP,NAG and GAL in the control group were lower than those in the observation group 1,2 and 3(P<0.05);the levels of Cys-C,RBP,NAG and GAL in the observation group 1 were lower than those in the observation group 2 and 3(P<0.05);the levels of Cys-C,RBP,NAG and GAL in the observation group 2 were lower than those in the observation group 3(P<0.05).The diagnostic compliance rates of the 4 combined detection of Cys-C,RBP,NAG and GAL in each observation group were higher than those of separated detection.The diagnostic compliance rates of the indicators in the observation group 3 separated and combined detection were higher than those in the observation group 1 and 2(P<0.05);the diagnostic compliance rates of the indicators in the observation group 2 separated and combined detection were higher than those in the observation group 1(P<0.05).Conclusion The levels of Cys-C,RBP,NAG and GAL in diabetic patients gradually increase with the increase of urinary albumin quantification,and the diagnostic compliance rate of the separated and combined detection of each indicator in the diagnosis of diabetic nephropathy also increase with the degree of renal damage.

关 键 词：糖尿病 糖尿病肾病 半胱氨酸蛋白酶抑制剂C 视黄醇结合蛋白 N-乙酰-Β-D氨基葡萄糖苷酶 β-D半乳糖苷酶 

分 类 号：R587.1[医药卫生—内分泌]