摘要
目的分析胱抑素C(Cys-C)、D-二聚体(D-D)及纤维蛋白原(FIB)对早期糖尿病肾病的诊断价值。方法选择2019年1月至2021年7月我院内分泌科就诊的1461例2型糖尿病患者作为研究对象,根据尿白蛋白/尿肌酐的比值(UACR)将其分为正常白蛋白尿(NA)组(UACR<30 mg/g,751例)、微量白蛋白尿(MA)组(UACR 30~300 mg/g,365例)和临床白蛋白尿(CP)组(UACR>300 mg/g,345例)。比较三组患者的Cys-C、D-D、FIB水平及其与UACR的相关性,采用ROC曲线分析Cys-C、D-D、FIB单独检测及三者联合检测对早期糖尿病肾病的诊断效能。结果NA组、MA组和CP组的Cys-C、D-D和FIB水平随着肾损伤的加重而逐渐升高,差异具有统计学意义(P<0.05)。Cys-C、D-D、FIB与UACR均呈正相关(r=0.564、0.391、0.476,P<0.001)。Cys-C、D-D和FIB联合检测诊断糖尿病肾病的效能最高(AUC=0.808,95%CI=0.785~0.830),单独检测中血清Cys-C对早期糖尿病肾病期的诊断效能较高(AUC=0.790,95%CI=0.767~0.813),其次为FIB和D-D。结论Cys-C、FIB和D-D与UACR呈正相关,三者联合检测可作为早期糖尿病肾病诊断的重要参考指标,对于监测该疾病的发生和发展具有诊断价值。
Objective To analyze the diagnostic value of cystatin C(Cys-C),D-dimer(D-D)and fibrinogen(FIB)in the diagnosis of early diabetic nephropathy.Methods A total of 1461 patients with type 2 diabetes were treated in the endocrinology department of our hospital from January 2019 to July 2021 were selected as the research objects.According to the urine albumin/creatinine ratio(UACR),the patients were divided into normal albuminuria(NA)group(UACR<30 mg/g,751 cases),microalbuminuria(MA)group(UACR 30-300 mg/g,365 cases)and clinical albuminuria(CP)group(UACR>300 mg/g,345 cases).The levels of Cys-C,D-D and FIB among the three groups and their correlation with UACR were compared,and ROC curve was used to analyze the diagnostic efficiency of Cys-C,D-D and FIB separate detection and three combined detection for early diabetic nephropathy.Results The levels of Cys-C,D-D and FIB in the NA group,the MA group and the CP group gradually increased with the aggravation of renal injury,and the differences were statistically significant(P<0.05).Cys-C,D-D,FIB and UACR were positively correlated(r=0.564,0.391,0.476,P<0.001).The combined detection of Cys-C,D-D and FIB has the highest diagnostic efficiency for early diabetic nephropathy(AUC=0.808,95%CI=0.785-0.830);among the single detection,the serum Cys-C was more effective in the diagnosis of early diabetic nephropathy(AUC=0.790,95%CI=0.767-0.813),followed by FIB and D-D.Conclusion Cys-C,FIB and D-D are positively correlated with UACR.The combination of the three indicators can be used as an important indicator for the diagnosis of early diabetic nephropathy.It has diagnostic value for monitoring the occurrence and development of the disease.
作者
王荔敏
张若
李春梦
王九菊
王玉环
WANG Limin;ZHANG Ruo;LI Chunmeng;WANG Jiuju;WANG Yuhuan(School of Basic Medicine,Xi'an Jiaotong University Health Science Center,Xi'an 710061;Shaanxi Traditional Chinese Medicine Hospital,Xi'an 710003;the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004;Xi'an Daxing Hospital,Xi'an 710016,China)
出处
《临床医学研究与实践》
2022年第3期8-10,共3页
Clinical Research and Practice
基金
西安市科技计划项目[No.SF1316(5)]
西安市科技计划项目[No.201805103YXIISF37(15)]。
