摘要
目的探讨胱抑素C(CysC)、同型半胱氨酸(HCY)、血β2微球蛋白(血β2-MG)、糖化血红蛋白(HbA1C)在糖尿病肾病(DN)诊断中的临床应用价值。方法选取2021年3月-2021年12月本院收治的糖尿病肾病患者95例(实验组)和同期健康者38例(对照组),按照病因-肾小球滤过率-白蛋白尿(CGA)分期,检测各组血清中CysC、HCY、血β2-MG、HbA1C、尿白蛋白/肌酐(UACR)及肾小球滤过率(GFR)之间的变化关系,并制作ROC曲线,分析CysC、HCY、血β2-MG、HbA1C及四者联合诊断DN的临床应用价值。结果(1)试验组血清CysC、HCY、血β2-MG和HbA1C检测水平显著高于对照组(P<0.05)。(2)在阳性率比较中,CysC+HCY+血β2-MG+HbA1C四者联合阳性检测率最高。(3)UACR中中度、大量白蛋白组中血清CysC、HCY、血β2-MG、HbA1C水平均高于正常至轻度蛋白组,差异有统计学意义(P<0.05)。(4)相关分析中发现CysC、HCY、β2-MG、HbA1C与GFR呈负相关(P<0.01);CysC、HCY、血β2-MG、HbA1C与UACR呈正相关(P<0.01)。(5)从ROC曲线可以看出,CysC+HCY+β2-MG+HbA1C四者联合曲线下面积为0.973,在各项指标中以四者联合诊断效能最高。结论血清中CysC、HCY、血β2-MG、HbA1C可作为DN早期诊断指标,而且联合检测可以提高DN早期肾损害检测率,并能够反映DN严重程度及疗效,具有较高临床意义。
Objective To explore clinical application effect of cystatin C(CysC),homocysteine(HCY),and bloodβ2 microglobulin(bloodβ2-MG)and HbA1C in diagnosis of diabetes nephropathy(DN).Methods The paper chose 95 patients with diabetes nephropathy(experimental group)and 38 healthy people(control group)in the same period admitted to our hospital from March 2021 to December 2021,and divided them into groups according to etiologyglomerular filtration rate-albuminuria(CGA),detected changes relationship between CysC,HCY and bloodβ2-MG,HbA1C,urinary albumin/creatinine(UACR),and glomerular filtration rate(GFR)in serum of each group,and made ROC curves to analyze clinical application value of CysC,HCY,and bloodβ2-MG,HbA1C,and their combination in diagnosis of DN.Results①Detection levels of serum CysC,HCY,and bloodβ2-MG and HbA1C in experimental group were significantly higher than control group(P<0.05).②Comparison showed,combined positive detection rate of CysC+HCY+bloodβ2-MG+HbA1C was the highest.③Serum CysC,HCY,and bloodβ2-MG and HbA1C levels in moderate and high albumin groups in UACR were higher than normal to mild protein group,with statistical significance(P<0.05).④Relevant analysis found,CysC,HCY,β2-MG,HbA1C was negatively correlated with GFR(P<0.01).CysC,HCY,Bloodβ2-MG,HbA1C was positively correlated with UACR(P<0.01).⑤ROC curve showed,area under combined curve of CysC+HCY+β2-MG+HbA1C was 0.973,with the highest diagnostic efficiency among all indicators.Conclusion CysC,HCY,and bloodβ2-MG and HbA1C in serum can be early diagnostic indicators for DN,and combined detection can improve detection rate of early renal damage of DN,reflect severity and effect of DN,which has high clinical significance.
作者
李孔旺
黄桂兰
谭恰
LI Kongwang;HUANG Guilan;TAN Qia(Yangjiang City Integrated Traditional Chinese and Western Medicine Hospital,Yangjiang,Guangdong 529500)
出处
《智慧健康》
2023年第10期68-71,76,共5页
Smart Healthcare
基金
广东省阳江市科学技术局科研项目《胱抑素C(CysC)、HCY、血β2-MG及HbA1C及其相关指标对糖尿病性肾病诊断及其临床应用》(项目编号:SF2021108)
作者简介
李孔旺(1981-),男,汉族,广东阳江,主管技师,本科,研究方向:检验科。
