糖尿病早期肾损害患者尿糖及血清Cys-C、游离轻链κ/λ比值的变化及临床意义  

Urinary Glucose,Serum Cys-C and Free Light Chain in Patients with Early Renal Damage in Diabetesκ/λthe Change of Ratio and its Clinical Significance

作　　者：沈肖明 魏权 林璐 SHEN Xiaoming;WEI Quan;LIN Lu(Department of Clinical Laboratory,Longyan People's Hospital,Longyan,Fujian Province,364000 China)

机构地区：[1]福建省龙岩人民医院检验科,福建龙岩364000

出　　处：《糖尿病新世界》2023年第5期1-5,共5页Diabetes New World Magazine

摘　　要：目的分析糖尿病(diabetes mellitus,DM)早期肾损害患者尿糖及血清胱抑素C(Cys-C)、游离轻链κ/λ比值的变化及临床意义。方法回顾性分析2020年11月—2022年11月在福建省龙岩人民医院进行治疗的172例2型糖尿病患者的临床资料,根据患者尿蛋白排泄率(UAER)将其分为DM组(n=94,UAER<30 mg/d,不存在早期肾损伤),早期DN组(n=78,UAER 30~300 mg/d,存在早期肾损伤)。比较两组患者尿糖、血清Cys-C及游离轻链κ、游离轻链λ及游离轻链κ/λ比值水平,并分析以上指标与早期DN的相关性。结果早期DN组患者尿糖水平、血清Cys-C、游离轻链κ、游离轻链λ以及游离轻链κ/λ比值均高于DM组患者,差异有统计学意义(P<0.05);尿糖、血清Cys-C及血清游离轻链κ/λ比值异常增高均为DM早期肾损害的危险因素(P<0.05);血清游离轻链κ/λ比值与尿糖水平及血清Cys-C水平均呈正相关(r=0.366、0.341,P<0.05);受试者工作特征(ROC)曲线分析显示,尿糖预测早期DN曲线下面积为0.758,敏感度为79.69%、特异性为71.43%;血清Cys-C预测早期DN曲线下面积为0.749,敏感度为70.31%、特异性为71.43%;游离轻链κ/λ比值预测早期DN曲线下面积为0.775,敏感度为84.37%、特异性为64.29%;三者联合预测早期DN诊断价值最高,曲线下面积为0.843,敏感度为73.44%、特异性为92.86%。结论DM患者尿糖、血清Cys-C与血清游离轻链κ/λ比值变化可提示患者早期DN进展,且早期DN患者尿糖、血清Cys-C与血清游离轻链κ/λ比值呈正相关,以上三者均具有临床诊断价值,但三者联合诊断价值最高。Objective Urinary glucose and serum cystatin C(Cys-C)and free light chains were analyzed in patients with early renal impairment due to diabetes mellitus(DM)κ/λChanges and clinical significance of ratios.Methods Retrospectively analyze the clinical data of 172 patients with type 2 diabetes who were treated in Fujian Longyan People's Hospital from November 2020 to November 2022,and divide them into DM group(n=94,UAER<30 mg/d,without early renal injury)and early DN group(n=78,UAER 30~300 mg/d,with early renal injury)according to their urinary protein excretion rate(UAER).Comparison of urine glucose,serum Cys-C,and free light chain between the two groups of patientsκ,Free light chainλAnd free light chainκ/λRatio level,and analyze the correlation between the above indicators and early DN.Results Urine glucose level,serum Cys-C,free light chainκin patients with early DN,free light chainλAnd free light chainsκ/λthe ratio was higher than that of patients in the DM group,and the differences were statistically significant(P<0.05);urine sugar,serum Cys-C,and serum free light chainκ/λAbnormal increase in ratio was a risk factor for early renal damage in DM(P<0.05);serum free light chainκ/λThe ratio was positively correlated with the levels of urine glucose and serum Cys-C(r=0.366,0.341,P<0.05);the analysis of the subject working characteristic(ROC)curve showed that the area under the DN curve for early prediction of urine glucose was 0.758,the sensitivity was 79.69%,and the specificity was 71.43%;The area under the curve of serum Cys-C for predicting early DN was 0.749,the sensitivity was 70.31%,and the specificity was 71.43%;Free light chainκ/λThe area under the curve of early DN predicted by the ratio was 0.775,the sensitivity was 84.37%,and the specificity was 64.29%;The combined prediction of the three factors has the highest diagnostic value for early DN,with an area under the curve of 0.843,a sensitivity of 73.44%,and a specificity of 92.86%.Conclusion Urine sugar,serum Cys-C,and serum free light chain

关 键 词：糖尿病 早期肾损害 尿糖 血清胱抑素C 游离轻链κ/λ比值 诊断价值 

分 类 号：R446.1[医药卫生—诊断学]