胱抑素C、同型半胱氨酸、超敏C反应蛋白联合检测对早期糖尿病肾损伤的诊断价值

杜超华 梁丽仪 陈健珍

[摘要] 目的 探析胱抑素C（Cys-C）、同型半胱氨酸（Hcy）、超敏C反应蛋白（hs-CRP）联合检测对早期糖尿病肾损伤的诊断价值。方法 选取该院2018年10月—2019年10月收治的糖尿病患者共计100例作為研究组，同期选取100名健康的体检者作为对照组。对比分析两组Hcy、Cys-C、hs-CRP等生化指标的差异，从而鉴定3种指标联合检测对于诊断早期糖尿病肾损伤的临床应用价值。 结果 研究组患者Hcy、Cys-C、hs-CRP检测值均显著高于对照组健康者（P<0.05）;对照组健康者其Hcy、Cys-C、hs-CRP均未检出异常，研究组异常率分别为68.00%、57.00%、63.00%，两组差异有统计学意义（P<0.05）;分析不同指标联合检测的阳性率，Hcy+Cys-C、Hcy+hs-CRP、Cys-C+hs-CRP、Hcy+Cys-C+hs-CRP阳性率分别为69.00%、73.00%、71.00%、89.00%，3种指标联合检测其阳性率最高。结论 在诊断早期糖尿病肾损伤中采取Hcy、Cys-C、hs-CRP联合检测，其灵敏度最高，对患者早期病情可以进行有效的预测判定。

[关键词] 早期糖尿病肾损伤;胱抑素C;同型半胱氨酸;超敏C反应蛋白

[中图分类号] R446.1          [文献标识码] A          [文章编号] 1672-4062（2020）07（b）-0031-03

[Abstract] Objective To explore the diagnostic value of combined detection of cystatin C （Cys-C）， homocysteine （Hcy） and hypersensitive C-reactive protein （hs-CRP） in early diabetic kidney injury. Methods A total of 100 diabetic patients admitted to the hospital from October 2018 to October 2019 were selected as the research group， and 100 healthy medical examinees were selected as the control group during the same period. Comparative analysis of the differences in biochemical indicators such as Hcy， Cys-C， hs-CRP between the two groups， so as to identify the clinical application value of the combined detection of the three indicators for the diagnosis of early diabetic kidney injury. Research results： the detection values of Hcy， Cys-C and hs-CRP in the study group were significantly higher than those in the healthy group of the control group （P<0.05）; the healthy persons in the control group did not detect abnormal Hcy， Cys-C and hs-CRP rates of the study group were 68.00%， 57.00%， and 63.00%， respectively. The difference between the two groups was statistically significant （P<0.05）; the positive rate of the combined detection of different indicators was analyzed， Hcy+Cys-C， Hcy+hs-CRP， Cys-C+hs-CRP and Hcy+Cys-C+hs-CRP were 69.00%， 73.00%， 71.00% and 89.00%， respectively. The positive rate of the three indicators combined detection was the highest. Conclusion The combined detection of Hcy， Cys-C， and hs-CRP in the diagnosis of early diabetic kidney injury has the highest sensitivity， and can effectively predict the early condition of patients.

[Key words] Early diabetic kidney injury; Cystatin C; Homocysteine; Hypersensitive C-reactive protein

糖尿病肾病（DN）是糖尿病发展至一定程度时较为严重的并发症之一，由于其发病具有一定的隐蔽性，因此在发病初期患者生理并无明显异常[1]，随着病情发展可能导致肾衰竭等严重后果。因此早期的判定治疗对患者恢复至关重要。临床有效的诊断是制定有效治疗方案的关键[2]。糖尿病患者病情发展后期其微血管会病变，同型半胱氨酸（Hcy）是通过内质网、氧化应激、致炎因子等各种途径对血管内皮功能产生消极影响;胱抑素C（Cys-C）是反映肾小球滤过率变化的最为理想的内源性标志物;超敏C反应蛋白（hs-CRP）是炎性反应的有效标志物，当糖尿病患者内皮功能受损或者出现炎症时其值明显升高。该研究选取该院2018年10月—2019年10月收治的糖尿病患者共计100例作为研究组，同期选取100名健康的体检者作为对照组，考察Cys-C、Hcy、hs-CRP联合检测对早期糖尿病肾损伤的诊断价值，现报道如下。