血清CysC联合TSH、FT3、FT4检测对2型糖尿病患者早期肾脏损伤的诊断价值  

Diagnostic value of serum CysC combined with TSH,FT3 and FT4 levels in early renal injury in patients with type 2 diabetes mellitus

作　　者：水应兰 陈众 常青 SHUI Yinglan;CHEN Zhong;CHANG Qing(Department of Laboratory,Luoyang Branch of Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine,Luoyang,Henan 471000,China)

机构地区：[1]北京中医药大学东直门医院洛阳医院检验科,河南洛阳471000

出　　处：《现代医药卫生》2025年第3期616-620,共5页Journal of Modern Medicine & Health

基　　金：河南省医学科技攻关计划项目(LHGJ20220491)。

摘　　要：目的 评估血清胱抑素C(CysC)联合促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)检测对2型糖尿病(T2DM)患者早期肾脏损伤的诊断价值。方法 选取2023年1月至2024年1月该院收治的T2DM患者190例作为研究对象,根据病理检查结果分为肾脏损伤组(86例)和非肾脏损伤组(104例),检测2组患者血清CysC、TSH、FT3、FT4水平,使用受试者工作特征(ROC)曲线分析血清CysC联合TSH、FT3、FT4检测对T2DM患者早期肾脏损伤的诊断价值,应用Spearman秩相关系数分析血清CysC联合TSH、FT3、FT4水平与肾脏损伤严重程度的相关性。结果 肾脏损伤组患者存在高血压史占比明显高于非肾脏损伤组,血清CysC、TSH水平均明显高于非肾脏损伤组,FT3、FT4水平均明显低于非肾脏损伤组,差异均有统计学意义(P<0.05)。高血压史、血清CysC、TSH水平升高,FT3、FT4水平降低均为T2DM患者发生肾脏损伤的危险因素(P<0.05);血清CysC联合TSH、FT3、FT4检测诊断肾脏损伤的ROC曲线下面积为0.789,各项单独诊断肾脏损伤的ROC曲线下面积分别为0.629、0.666、0.654、0.683,联合检测的诊断价值均明显高于各项单独检测,差异有统计学意义(P<0.05)。血清CysC、TSH水平与T2DM患者肾脏损伤严重程度均呈正相关(r=0.244、0.289,P<0.001、<0.001),FT3、FT4水平与T2DM患者肾脏损伤严重程度均呈负相关(r=-0.284、-0.316,P<0.001、<0.001)。结论 血清CysC、TSH、FT3、FT4水平均与T2DM患者肾脏损伤的发生存在一定相关性,对早期肾脏损伤具有重要诊断价值。Objective To evaluate the diagnostic value of serum cystatin C(CysC)combined with thyroid stimulating hormone(TSH),free triiodothyronine(FT3)and free thyroxine(FT4)in early renal injury in patients with type 2 diabetes mellitus(T2DM).Methods A total of 190 patients with T2DM admitted to our hospital from January 2023 to January 2024 were selected as the research objects.According to the results of pathological examination,they were divided into the renal injury group(86 cases)and the non-renal injury group(104 cases).The levels of serum CysC,TSH,FT3 and FT4 were detected in the two groups.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum CysC combined with TSH,FT3 and FT4 in early renal injury in patients with T2DM.Spearman rank correlation coefficient was used to analyze the correlation between serum CysC combined with TSH,FT3,FT4 levels and the severity of renal injury.Results The proportion of patients with a history of hypertension in the renal injury group was significantly higher than that in the non-renal injury group,the serum CysC and TSH levels were significantly higher than those in the non-renal injury group,and the FT3 and FT4 levels were significantly lower than those in the non-renal injury group,with statistically significant differences(P<0.05).The risk of renal injury was related to the history of hypertension,the increase of serum CysC and TSH levels,and the decrease of FT3 and FT4 levels(P<0.05).The area under the ROC curve of serum CysC combined with TSH,FT3 and FT4 in the diagnosis of renal injury was 0.789,and the area under the ROC curve of each single diagnosis of renal injury was 0.629,0.666,0.654 and 0.683,respectively.The diagnostic value of combined detection was significantly higher than that of each single detection,and the difference was statistically significant(P<0.05).Serum CysC and TSH levels were positively correlated with the severity of renal injury(r=0.244,0.289,P<0.001,<0.001),while FT3 and FT4 levels were negatively correlat

关 键 词：血清CYSC 促甲状腺激素 游离三碘甲状腺原氨酸 游离甲状腺素 2型糖尿病 肾脏损伤 诊断价值 

分 类 号：R587.1[医药卫生—内分泌] R446.61[医药卫生—内科学]