血尿酸和胱抑素C与糖尿病视网膜病变患者合并糖尿病肾病的关系及影响因素  

Relationship between serum uric acid combining cystatin C and diabetic kidney disease in patients with diabetic retinopathy and influencing factors

作　　者：程莉[1] 章晓良[1] Cheng Li;Zhang Xiaoliang(910^(th)Hospital,Joint Logistic Support Force of Chinese PLA,Quanzhou 362000,Fujian Province,China)

机构地区：[1]中国人民解放军联勤保障部队第九一〇医院,泉州362000

出　　处：《中华肾病研究电子杂志》2023年第4期194-199,共6页Chinese Journal of Kidney Disease Investigation（Electronic Edition）

摘　　要：目的探讨血清尿酸(SUA)、胱抑素C(Cys-C)与糖尿病视网膜病变(DR)合并糖尿病肾病(DKD)的关系及影响因素。方法回顾性研究2021年7月至2022年6月我院收治217例DR患者的临床资料,将患者分为合并DKD组(54例)和未合并DKD组(163例)。比较两组SUA、Cys-C水平,分析SUA、Cys-C与DR合并DKD的关系以及影响因素。结果合并DKD组SUA、Cys-C明显高于未合并DKD组(P<0.05)。受试者工作特征(ROC)曲线分析显示,SUA、Cys-C曲线下面积(AUC)分别为0.844、0.825,敏感度、特异度分别为:SUA为77.8%、84.0%,Cys-C为88.9%、63.2%。二者联合的AUC为0.926,敏感度为97.4%,特异度为77.3%。经多因素二元Logistic回归分析,高SUA(95%CI:1.001~1.049,P=0.038)、高Cys-C(95%CI:1.253~4.070,P=0.036)、高血肌酐(Scr,95%CI:1.036~1.266,P=0.008)和高眼底病变评分(95%CI:1.231~13.482,P=0.021)是DR合并DKD的影响因素,而白蛋白(ALB)和服用他汀类药物可能具有保护作用(P<0.05)。结论SUA、CysC在DR合并DKD患者中呈高表达,二者联合可能具有一定预测价值。SUA、CysC、Scr和眼底病变评分增高是DR患者合并DKD的影响因素。Objective To explore the relationship between serum uric acid(SUA)combining cystatin C(Cys-C)and diabetic kidney disease(DKD)in patients with diabetic retinopathy(DR)and influencing factors.Methods A retrospective study was conducted on the clinical data of 217 DR patients admitted to our hospital from July 2021 to June 2022.The patients were divided into a DKD-complicating group of 54 cases and non-DKD-complicating group of 163 cases.The two groups were compared in the levels of SUA and Cys-C,and it was analyzed including the relationship between SUA combining Cys-C and DKD in patients with DR,as well as the influencing factors.Results The SUA and Cys-C levels in the DKD-complicating group were significantly higher than those in the non-DKD-complicating group(P<0.05).The receiver operating characteristic(ROC)curve analysis showed that the areas under the curve(AUC)of SUA and Cys-C were 0.844 and 0.825,respectively.The sensitivity and specificity were 77.8%and 84.0%for SUA and 88.9%and 63.2%for Cys-C.The AUC of the combination of SUA and Cys-C was 0.926 with a sensitivity of 97.4%and a specificity of 77.3%.Through multivariate binary logistic analysis,the increase of SUA(95%CI:1.001-1.049,P=0.038),Cys-C(95%CI:1.253-4.070,P=0.036),serum creatinine(Scr,95%CI:1.036-1.266,P=0.008)and fundus lesionscore(95%CI:1.231-13.482,P=0.021)were the influencing factors for DKD complication in DR patients,while albumin(ALB)and statins taking may have a potential protective role(P<0.05).Conclusion SUA and Cys-C levels were increased in DR patients complicated with DKD.The combination of SUA and Cys-C may have certain predictive value.Elevated SUA,Cys-C,Scr,and fundus lesion scores were influencing factors for the DKD complication in the patients with DR.

关 键 词：血尿酸 胱抑素C 糖尿病视网膜病变 糖尿病肾病 影响因素 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学] R774.1[医药卫生—临床医学]