右江医学2017，Vol.45Issue(2)：138-141,4.DOI:10.3969/j.issn.1003-1383.2017.02.003
多指标联合检测在糖尿病肾病早期诊断中的临床应用
Clinical value of combined detection of multiple markers in early diagnosis of diabetic nephropathy
摘要
Abstract
Objective To investigate the clinical value of combined detection of serum cystatin C(Cys C),homocysteine(Hcy),β2-microglobulin (β2-MG) and microalbuminuria(mAlb) in early diagnosis of diabetic nephropathy(DN).Methods 264 cases of type 2 diabetes mellitus(T2DM) patients were selected as research objects and divided into two observation groups,that was,132 DN patients were selected as DN group,and 132 patients with simple diabetes mellitus as T2DM group.And another 132 healthy subjects were selected as control group.And then,serum levels of Cys C,β2-MG and mAlb were determined by latex enhanced immune scattering turbidimetry on Beckman Kurt AU680 automatic biochemical analyzer.Serum level of Hcy was measured by enzyme kinetic method on Roche Cobas E411 automatic electrochemiluminescence immunoassay analyzer.Test results of each index were compared and analyzed among all groups.Results Compared with the control group,detection results of Cys C,Hcy,β2-MG,mAlb of the DN group and T2DM group all significantly increased(P<0.01),and the detection results of the four indexes of the DN group increased more significantly(P<0.01).Correlation analysis showed that the Cys C was positively correlated with Hcy(r=0.663,P<0.05),Cys C,Hcy and mAlb were negatively correlated(r=-0.712,-0.632,all P<0.05),while Cys C,Hcy,mAlb were all not significantly correlated with β2-MG.ROC curve analysis results also showed that area under the ROC curve of Cys C,Hcy,β2-MG and mAlb were 0.815,0.916,0.807 and 0.783,respectively,standard errors(s(x)) was 0.050,0.023,0.045 and 0.018,respectively,95% confidence intervals was 0.736~0.893,0.875~0.965,0.733~0.885 and 0.712~0.865,respectively.The positive rate of combined detection of the four indicators (Cys C+Hcy+β2-MG+mAlb) was 96.21%(127/132),that of combined detection of the three indicators (Cys C+Hcy+β2-MG) was 90.15%(119/132),and that of combined detection of the two indicators (Cys C+Hcy) was 84.10%(119/132),all significantly higher than that 71.96%(95/132) of single index (Cys C).Conclusion Regular monitoring for changes of indexes like Cys C,Hcy,β2-MG and urine mAlb can help to understand the development of diabetic nephropathy patients,and its clinical value is better than that of single observation index.Thus, it is worthy of popularization and application.关键词
血清胱抑素C/同型半胱氨酸/β2-微球蛋白/尿微量白蛋白/糖尿病肾病Key words
Cys C/Hcy/β2-MG/mAlb/DN分类
医药卫生引用本文复制引用
黄颢,韦凤英,潘国刚,邓益斌..多指标联合检测在糖尿病肾病早期诊断中的临床应用[J].右江医学,2017,45(2):138-141,4.基金项目
国家自然科学基金(81460123) （81460123）
百色市科学研究与技术开发计划项目(百科计字(2016)14号) （百科计字(2016）
百色市右江区科学研究与技术开发计划项目(右科计字(2016)1号) （右科计字(2016）
