血清CysC與尿NAG、RBP聯合檢測在2型糖尿病早期腎損傷中的應用

任風梅

[摘要] 目的 探討血清血清胱抑素（CysC）與尿β-N-乙酰葡萄糖苷酶（NAG）、尿視黃醇結合蛋白（RBP）聯合檢測在2型糖尿病早期腎損傷中的應用。方法 選擇2018年5月—2019年5月該院收治的47例2型糖尿病早期腎損傷患者作為研究組，選擇同期該院收治的47例2型糖尿病患者作為對照組。對比兩組患者血清CysC與尿液NAG、RBP水平。同時，對比單項血清CysC指標、尿液NAG、RBP指標與3項指標聯合診斷2型糖尿病早期腎損傷的陽性率。結果 研究組血清CysC指標與尿液NAG、RBP指標均高于對照組（P<0.05）。3項指標聯合診斷的陽性率95.74%高于單項血清CysC指標陽性率76.60%、尿液NAG陽性率74.47%與RBP陽性率76.60%（P<0.05）。結論 血清CysC與尿NAG、RBP聯合檢測2型糖尿病早期腎損傷效果可靠。

[關鍵詞] 血清CysC;尿NAG;RBP;2型糖尿病;早期腎損傷

[中圖分類號] R59? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1672-4062（2020）07（a）-0194-03

Application of Combined Detection of Serum CysC， Urine NAG and RBP in Early Renal Injury of Type 2 Diabetes

REN Feng-mei

Wucheng County Traditional Chinese Medicine Hospital， Wucheng， Shandong Province，? 253300 China

[Abstract] Objective To explore the application of combined detection of serum cystatin （CysC）， urine β-N-acetylglucosidase （NAG） and urinary retinol binding protein （RBP） in early renal injury of type 2 diabetes. Methods From May 2018 to May 2019， 47 patients with type 2 diabetes and early kidney injury treated in the hospital were selected as the research group， and 47 patients with type 2 diabetes admitted in the hospital during the same period were selected as the control group. The serum CysC and urine NAG and RBP levels were compared between the two groups. At the same time， the positive rate of early diagnosis of kidney injury in type 2 diabetes was compared between the single serum CysC index， urine NAG， RBP index and three indexes. Results The serum CysC index and urine NAG and RBP indexes in the study group were higher than those in the control group（P<0.05）. The positive rate of the combined diagnosis of the three indicators was 95.74% higher than the single serum CysC indicator positive rate of 76.60%， urine NAG positive rate of 74.47% and RBP positive rate of 76.60%（P<0.05）. Conclusion The combination of serum CysC， urine NAG and RBP in the detection of early renal injury in type 2 diabetes is reliable.

[Key words] Serum CysC; Urine NAG; RBP; Type 2 diabetes; Early kidney injury

糖尿病腎病是2型糖尿病患者常見的并發癥，具有起病隱匿、進展慢等特點，且早期腎損傷癥狀不具備典型性，甚至部分患者微量蛋白尿與腎小球濾過功能亢進持續多年也未覺察，致使病機延誤[1]。傳統診斷早期腎損傷的方法包括血尿素氮（BUN）與肌酐（Cr），但部分研究發現此類指標的敏感性較差[2]。有研究根據糖尿病早期腎損傷患者腎功能與結構的變化，發現新型標志物β-N-乙酰葡萄糖苷酶（NAG）、尿視黃醇結合蛋白（RBP）與血清胱抑素（CysC）對糖尿病腎病具有一定的診斷意義[3]。該研究回顧性分析2018年5月—2019年5月該院對47例2型糖尿病早期腎損傷患者的資料，將其血清CysC與尿NAG、RBP聯合檢測結果與單純糖尿病患者進行對比，以期為完善2型糖尿病早期腎損傷患者的診療方案提供可靠的參考，現報道如下。