【摘要】 目的探讨尿白蛋白(UALB)、血清胱抑素C(Cys C)和基于胱抑素C估算的肾小球滤过率(e GFR-CysC)对评价2型糖尿病合并亚甲减患者肾功能的价值。方法对符合纳入标准的30例2型糖尿病合并亚甲减患者(观察组)及同期63例单纯2型糖尿病患者(对照组)的甲状腺功能、尿素、肌酐、胱抑素C、糖化血红蛋白及晨尿白蛋白进行检测,比较两组各指标差异,分析指标对评价两组肾功能改变的价值。结果观察组患者的血清Cys C、UALB均高于对照组,而e GFR-CysC低于对照组(P<0. 05)。以GFR<90 m L/min/1. 73 m~2作为肾功能已轻度受损的判断标准,观察组UALB排泄量小于30 mg/L的患者中出现肾损伤的比例高于对照组(66. 67%vs 42. 11%,P<0. 05)。结论亚甲减可加重2型糖尿病肾损伤,单测UALB有可能引起漏诊,应联合应用UALB、Cys C和e GFR-CysC评价2型糖尿病合并亚甲减患者是否出现肾损伤。更多还原

【Abstract】 Objective To investigate the value of urinary albumin( UALB),serum cystatin C( Cys C) and glomerular filtration rate based on cystatin C( e GFR-CysC) in the evaluation of renal function in patients with type 2 diabetes mellitus with subcutaneous hypothyroidism. Methods The thyroid function,urea,creatinine,cystatin C,glycosylated hemoglobin and morning urinary albumin of 30 patients with type 2 diabetes mellitus combined with hypothyroidism( observation group) and 63 patients with simple type 2 diabetes( control group) was tested and the differences between the two groups were compared. The value of the indicators was evaluated for the evaluation of renal function changes in the two groups. Results The serum Cys C and UALB of the observation group were higher than those of the control group,while the e GFR-CysC was lower than the control group( P< 0. 05). When GFR<90 m L/min/1. 73 m~2 was used as the criterion for mild impairment of renal function,the proportion of renal injury in patients with UALB excretion less than 30 mg/L was higher in the observation group than in the control group( 66. 67% vs 42. 11%,P<0. 05). Conclusion Hypothyroidism can aggravate renal damage in type 2 diabetic patients. Single-label UALB may cause missed diagnosis and UALB,Cys C and e GFR-CysC should be combined used to evaluate whether type 2 diabetes mellitus combined with hypothyroidism has renal injury.更多还原