CystatinC在2型糖尿病和高血压病患者早期肾功能损伤中的诊断价值

【作者】 廖明星；

【导师】 张朝明；

【作者基本信息】 成都中医药大学 ， 中西医结合临床， 2008， 硕士

【摘要】 目的:探讨胱氨酸蛋白酶抑制剂C（CystatinC）在评价2型糖尿病患者及高血压病患者早期肾功能损伤中的应用价值。方法:收集2型糖尿病患者、高血压病患者及正常对照共90例,采用颗粒增强散射免疫比浊法（PENIA）测定血、尿CystatinC浓度,同时测定每例患者的血肌酐（Scr）、尿微量白蛋白（MAU）与α₁微球蛋白（α₁-MG）。以MAU阳性作为诊断糖尿病、高血压病继发早期肾功能损伤的“灵敏指标”,比较Scr、血CystatinC、尿α₁-MG与MAU的相关性。用受试者工作特征曲线下面积评价CystatinC诊断结果的准确性。结果:以MAU阳性为诊断出现早期肾损害的标准,30例糖尿病患者中早期肾损害有16例（占53.33%）,30例高血压病患者中早期肾损害有10例（占33.33%）。糖尿病组Scr、血CystatinC、尿CystatinC、尿α₁-MG、MAU与正常对照组比较P均小于0.05;而与MAU的相关系数比较,血CystatinC最高为0.869;受试者工作特征曲线下面积(AUC^ROC)比较血CystatinC最高,诊断准确性明显高于Scr（P＜0.05）,与尿CystatinC、尿α₁-MG相比没有差别（P＞0.05）。高血压病组Scr、血CystatinC、尿CystatinC、MAU与正常对照组比较P均小于0.01,尿α₁-MG＞0.05;而与MAU的相关系数比较,血CystatinC最高为0.807;AUC^ROC比较,血CystatinC最高,诊断准确性明显高于Scr和尿CystatinC（P＜0.05）,而与尿α₁-MG相比没有差别（P＞0.05）。结论:与Scr、α₁-MG相比,CystatinC是一个更为准确、可靠的反映2型糖尿病、高血压病早期肾功能损伤的指标,在2型糖尿病、高血压病出现早期肾功能损伤中具有重要的参考价值。更多还原

【Abstract】 Objective:To study diagnostic value of CystatinC for early renal injury in diabetes patients and hypertension patients.Methods:Patients with type 2 diabetes,hypertension patients and normal controls a total of 90 cases,serum and urine CystatinC were determinationed by the particle-enhanced nephelometric immunoassary,at the same time,everyone’s serum creatinine and microalbuminuria and urineα₁ microglobulin were determinationed.It is the "sensitive targets" of early renal injure for microalbuminuria in diabetes and hypertension,and compared with serum creatinine,serum Cystatin C,α₁-MG,find correlation of theirs.The area under receiver operating characteristic curve evaluated CystatinC accuracy of diagnosis.Results:There were 16 cases of patients that had early renal injure in 30 cases of patients with diabetes（53.33%）;There were 10 cases of patients that had early renal injure in 30 cases of patients with hypertension（33.33%）. The levels of serum creatinine,serum CystatinC,urine CystatinC,α₁-MG and MAU in diabetes group were higher than those in controls（P＜0.05）,With MAU compared the correlation coefficient, serum CystatinC up to 0.869;with the area under receiver operating characteristic curve,serum CystatinC is in the first,It was higher than that of serum creatinine in diagnostic accuracy（P＜0.05）,there was no difference with urine CystatinC andα₁-MG（P＞0.05）.The levels of serum creatinine,serum CystatinC,urine CystatinC and MAU in hypertension group were significantly higher than those in controls（P＜0.01）,and no difference withα₁-MG（P＞0.05）;With MAU compared the correlation coefficient,serum CystatinC up to 0.807;with the area under receiver operating characteristic curve,serum CystatinC was the highest,It was higher than that of serum creatinine and urine CystatinC in diagnostic accuracy（P＜0.05）,there was no difference withα₁-MG （P＞0.05）Conclusions:Compared with other indicators,CystatinC is a more accurate and reliable reflection of the early indicators of renal injure,It is of value in detecting the degree of early renal injury in patients with diabetes and hypertensions.更多还原