血清同型半胱氨酸、胱抑素C、尿微量白蛋白/肌酐诊断早期糖尿病肾病的价值分析  

Diagnostic value of serum homocysteine,cystatin C and urinary microalbumin/creatinine in early diabetic nephropathy

作　　者：栾迪 张连军[2,3] LUAN Di;ZHANG Lian-jun(Department of Clinical Laboratory,Qingdao Licang District Geriatric Hospital(Qingdao Licang District Central Hospital),Qingdao 266041,China)

机构地区：[1]青岛市李沧区老年病医院(青岛市李沧区中心医院)检验科,266041 [2]山东第二医科大学附属济南市第五人民医院,250022 [3]济南市老年病医院,250022

出　　处：《中国现代药物应用》2024年第18期75-78,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 分析血清同型半胱氨酸(Hcy)、胱抑素C(Cys-C)、尿微量白蛋白(mAlb)/肌酐(Cr)诊断早期糖尿病肾病(DN)的价值。方法 选取98例2型糖尿病(T2DM)患者,对其资料进行回顾性分析,根据诊断情况将患者分为早期DN组(40例)与单纯T2DM组(58例)。两组患者均接受血清Hcy、Cys-C与mAlb/Cr检验。比较单纯T2DM组与早期DN组患者血清Hcy、Cys-C与mAlb/Cr以及血清Hcy、Cys-C与mAlb/Cr单项指标与三项指标联合诊断早期DN的效能(敏感度、特异度与符合率)。结果 与单纯T2DM组[(14.03±2.65)μmol/L、(0.76±0.18)mg/L、(20.03±3.00)mg/g]相比,早期DN组患者血清Hcy(25.02±4.56)μmol/L、Cys-C(1.65±0.35)mg/L与mAlb/Cr(62.56±6.52)mg/g更高,差异有统计学意义(P<0.05)。血清Hcy、Cys-C与mAlb/Cr单项指标及三项指标联合诊断早期DN的敏感度分别为70.00%、75.00%、77.50%、95.00%,特异度分别为75.86%、77.59%、79.31%、94.83%,符合率分别为73.47%、76.53%、78.57%、94.90%。与单项血清Hcy、Cys-C与mAlb/Cr诊断相比, Hcy+Cys-C+mAlb/Cr联合诊断早期DN的敏感度、特异度、符合率更高,差异有统计学意义(P<0.05)。结论 早期DN患者的血清Hcy、Cys-C、mAlb/Cr可见明显升高,其中三项指标联合诊断效能更高,具有临床应用价值。Objective To analyze the value of serum homocysteine(Hcy),cystatin C(Cys-C)and urinary microalbumin/creatinine(mAlb/Cr)in early diabetic nephropathy(DN).Methods 98 patients with type 2 diabetes mellitus(T2DM)were selected and their data were retrospectively analyzed,and the patients were divided into an early DN group(40 patients)and a T2DM group(58 patients)according to their diagnosis.Serum Hcy,Cys-C and mAlb/Cr tests were performed in both groups.Comparison was made on serum Hcy,Cys-C and mAlb/Cr between the T2DM group and the early DN group,as well as the efficiency(sensitivity,specificity and compliance rate)of serum Hcy,Cys-C and mAlb/Cr alone and in combination for the diagnosis of early DN.Results Compared with T2DM group[(14.03±2.65)μmol/L,(0.76±0.18)mg/L,(20.03±3.00)mg/g],the early DN group had higher serum Hcy of(25.02±4.56)μmol/L,Cys-C of(1.65±0.35)mg/L and mAlb/Cr of(62.56±6.52)mg/g,and the difference was statistically significant(P<0.05).The sensitivity of serum Hcy,Cys-C and mAlb/Cr alone and in combination for the diagnosis of early DN were 70.00%,75.00%,77.50%,95.00%,the specificity were 75.86%,77.59%,79.31%,94.83%,and the compliance rate were 73.47%,76.53%,78.57%,and 94.90%.Compared with serum Hcy,Cys-C&mAlb/Cr alone,Hcy+Cys-C+mAlb/Cr combined diagnosis of early DN had higher sensitivity,specificity and compliance rate,and the difference was statistically significant(P<0.05).Conclusion Serum Hcy,Cys-C and mAlb/Cr are significantly increased in patients with early DN,and the combined diagnosis efficiency of these three indicators is higher,which has clinical application value.

关 键 词：同型半胱氨酸 胱抑素C 尿微量白蛋白/肌酐 早期糖尿病肾病 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]