摘要
目的 探讨血清同型半胱氨酸(homocysteine,Hcy)、胱抑素C(cystatin C,CysC)和超敏C反应蛋白(highsensitivity C-reactive protein,hsCRP)联合检测在早期糖尿病肾病(diabetic nephropathy,DN)诊断中的价值。方法选取2017年4月到2017年8月本院糖尿病科87例2型糖尿病(diabetes mellitus,DM)患者,根据尿白蛋白/肌酐比(urinary albumin creatinine ratio,UACR)将其分为正常尿白蛋白组(30例)、微量尿白蛋白组(28例)和大量尿白蛋白组(29例),同时选取本院体检中心64例健康者作为对照组。对DM患者及健康体检者血清Hcy、CysC、和hsCRP进行检测并对结果进行统计学分析,同时做Pearson相关性分析和受试者工作曲线(ROC曲线)分析。结果 正常尿白蛋白组、微量尿白蛋白组和大量尿白蛋白组Hcy、CysC和hsCRP检测结果明显高于对照组,差异有统计学意义(P<0.05)。大量尿白蛋白组Hcy、CysC和hsCRP检测结果明显高于微量尿白蛋白组和正常尿白蛋白组,差异有统计学意义(P<0.05)。微量尿白蛋白组Hcy、CysC和hsCRP检测结果明显高于正常尿白蛋白组,差异有统计学意义(P<0.05)。DM患者的血清Hcy、CysC和hsCRP水平与UACR呈正相关(r分别为0.552,0.599,0.439,P<0.05);通过ROC曲线显示血清Hcy、CysC和hsCRP联合检测的ROC曲线下面积是0.95,显著高于单独检测Hcy曲线下面积0.87、单独检测CysC曲线下面积0.92和单独检测hsCRP曲线下面积0.83。结论 血清Hcy、CysC、和hsCRP对早期DN有一定的诊断价值,联合检测可提高诊断效能。
Objective To investigate the diagnostic value of combined detection of serum homocysteine(Hcy),cystatin C(CysC)and high-sensitivity C-reactive protein(hsCRP)in the diagnosis of early(DN).Methods 87 patients with type 2 diabetes mellitus(DM)were selected from April 2017 to August 2017.According to urinary albumin creatinine ratio(UACR),it was divided into normal urinary albumin group(30 cases),microalbuminuria group(28 cases)and a large number of urinary albumin groups(29 cases),At the same time,64 cases of healthy persons were selected as control group.The serum homocysteine,CysC,and hsCRP of DM patients and healthy examinees were measured and the results were statistically analyzed,and the Pearson correlation analysis and Receiver Operating Characteristic curve(ROC curve)were analyzed.Results The detection results of homocysteine,CysC and hsCRP in normal urinary albumin group,microalbuminuria Group and urinary albumin group were significantly higher than those in control group,and the difference was statistically significant(P<0.05).The results of homocysteine,CysC and hsCRP in a large number of urinary albumin groups were significantly higher than those in Microalbuminuria group and normal urinary albumin group(P<0.05).The detection results of homocysteine,CysC and hsCRP in microalbuminuria group were significantly higher than those of normal urinary albumin group(P<0.05).The serum homocysteine,CysC and hsCRP levels in DM patients were positively correlated with UACR(r respectively 0.552,0.599,0.439,P<0.05).The serum homocysteine was shown by ROC curve.The CysC and hsCRP combined detection under the ROC curve area of 0.95,significantly higher than the individual detection of homocysteine curve under the area of 0.87,the individual detection of the CysC curve under the area of 0.92 and individual detection of the hsCRP curve under area 0.83.Conclusion Serum homocysteine,CysC,and hsCRP have some diagnostic value for early DN,and combined detection can improve the diagnostic efficiency.
作者
王洪飞
郭丽
林佳静
张炜
崔云
WANG Hong-fei;GUO Li;LIN Jia-jing(Department of Laboratory Diagnosis,Cangzhou Combination of Traditional Chineseand Western Medicine of Hebei Province,Cangzhou 061001,China)
出处
《中国实验诊断学》
2019年第12期2048-2051,共4页
Chinese Journal of Laboratory Diagnosis
基金
河北省卫计委重点科技研究计划(NO:20171189)
关键词
糖尿病肾病
同型半胱氨酸
胱抑素C
超敏C反应蛋白
Diabetic nephropathy
Homocysteine
Cystatin C
High-sensitivity C-reactive protein
