CAJ | 학술논문

目的探讨血清胱抑素C(CysC)和尿α1‐微球蛋白(α1‐MG)在糖尿病肾病(DN)早期诊断中的价值.方法将524例2型糖尿病患者按尿微量清蛋白(mAlb)水平分为3组,mAlb正常组0~30 mg/L ,mAlb 31~100 mg/L组和mAlb>100 mg/L组.定量测定各组患者血清中CysC、肌酐(Cr)、尿素氮(BUN)、α1‐MG的浓度.结果mAlb正常组与健康对照组比较,BUN、Cr差异无统计学意义(P>0.05);3组糖尿病患者的血CysC 和尿α1‐MG水平较健康对照组均显著升高(P<0.05),并随着mAlb的上升而升高.血CysC和尿α1‐MG的阳性检出率在3组糖尿病患者中均高于BUN和Cr(P<0.05).血CysC和尿α1‐MG联合检测,其阳性检出率在mAlb正常组中明显高于单项指标检出率,差异有统计学意义(P<0.05).在肾功能早期病变(患者mAlb<100 mg/L )的糖尿病患者中,各指标的阳性检出率由高到低为血CysC联合尿α1‐MG>尿α1‐MG>血CysC>BUN>Cr.结论血CysC和尿α1‐MG对糖尿病肾病的早期诊断较Cr和BUN更有意义,联合检测血CysC和尿α1‐MG可显著提高糖尿病早期肾损害的阳性检出率.
목적탐토혈청광억소C(CysC)화뇨α1‐미구단백(α1‐MG)재당뇨병신병(DN)조기진단중적개치.방법장524례2형당뇨병환자안뇨미량청단백(mAlb)수평분위3조,mAlb정상조0~30 mg/L ,mAlb 31~100 mg/L조화mAlb>100 mg/L조.정량측정각조환자혈청중CysC、기항(Cr)、뇨소담(BUN)、α1‐MG적농도.결과mAlb정상조여건강대조조비교,BUN、Cr차이무통계학의의(P>0.05);3조당뇨병환자적혈CysC 화뇨α1‐MG수평교건강대조조균현저승고(P<0.05),병수착mAlb적상승이승고.혈CysC화뇨α1‐MG적양성검출솔재3조당뇨병환자중균고우BUN화Cr(P<0.05).혈CysC화뇨α1‐MG연합검측,기양성검출솔재mAlb정상조중명현고우단항지표검출솔,차이유통계학의의(P<0.05).재신공능조기병변(환자mAlb<100 mg/L )적당뇨병환자중,각지표적양성검출솔유고도저위혈CysC연합뇨α1‐MG>뇨α1‐MG>혈CysC>BUN>Cr.결론혈CysC화뇨α1‐MG대당뇨병신병적조기진단교Cr화BUN경유의의,연합검측혈CysC화뇨α1‐MG가현저제고당뇨병조기신손해적양성검출솔.
Objective The aim of the study was to investigate the diagnostic value of serum cystatin C (CysC) and urinary α1‐microglobulin(α1‐MG) in the early diabetic nephropathy .Methods The 524 type 2 diabetics in this study were divided into three different groups (mAlb normal group 0-30 mg/L ,mAlb 31-100 mg/L,mAlb>100 mg/L) according to their Urinary microglobulin (mAlb) value .Serum CysC ,urinary α1‐MG ,BUN and Cr were meas‐ured in all individuals .Results By contrast to healthy control ,the concentration of blood urea nitrogen (BUN) and creatinine(Cr) had not significantly increased in mAlb normal group(0-30 mg/L)(P>0 .05) .However ,the levels of serum CysC and urinary α1‐MG significantly increased in three different groups of diabetics compared with healthy control(P<0 .05) ,and in a mAlb concentration dependent manner .The positive rates of serum CysC and urinary α1‐MG were higher than those of BUN and Cr in three different groups of diabetics (P<0 .05) .Combined measure of se‐rum CysC and urinaryα1‐MG remarkably increased the positive rate in mAlb normal group (0-30 mg/L) ,and the re‐sult was better than serum CysC or urinary α1‐MG alone(P<0 .05) .The positive rate sequence of 4 testing items in diabetics groups with early impairment of renal function (mAlb 0 -30 mg/L and mAlb 31 -100 mg/L ) was serum CysC + urinaryα1‐MG > urinaryα1‐MG > serum CysC > BUN>Cr .Conclusion Serum CysC and urinary α1‐MG are more efficacious than serum BUN and Cr in early diagnosis of diabetic nephropathy ,and combined test of serum CysC and urinary α1‐MG can significantly increase the positive rate of early renal impairment in diabetic patients .