胱抑素C、同型半胱氨酸、超敏C反應蛋白聯合檢測對早期糖尿病腎損傷的診斷價值

杜超華 梁麗儀 陳健珍

[摘要] 目的 探析胱抑素C（Cys-C）、同型半胱氨酸（Hcy）、超敏C反應蛋白（hs-CRP）聯合檢測對早期糖尿病腎損傷的診斷價值。方法 選取該院2018年10月—2019年10月收治的糖尿病患者共計100例作為研究組，同期選取100名健康的體檢者作為對照組。對比分析兩組Hcy、Cys-C、hs-CRP等生化指標的差異，從而鑒定3種指標聯合檢測對于診斷早期糖尿病腎損傷的臨床應用價值。 結果 研究組患者Hcy、Cys-C、hs-CRP檢測值均顯著高于對照組健康者（P<0.05）;對照組健康者其Hcy、Cys-C、hs-CRP均未檢出異常，研究組異常率分別為68.00%、57.00%、63.00%，兩組差異有統計學意義（P<0.05）;分析不同指標聯合檢測的陽性率，Hcy+Cys-C、Hcy+hs-CRP、Cys-C+hs-CRP、Hcy+Cys-C+hs-CRP陽性率分別為69.00%、73.00%、71.00%、89.00%，3種指標聯合檢測其陽性率最高。結論 在診斷早期糖尿病腎損傷中采取Hcy、Cys-C、hs-CRP聯合檢測，其靈敏度最高，對患者早期病情可以進行有效的預測判定。

[關鍵詞] 早期糖尿病腎損傷;胱抑素C;同型半胱氨酸;超敏C反應蛋白

[中圖分類號] R446.1 ? ? ? ? ?[文獻標識碼] A ? ? ? ? ?[文章編號] 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

糖尿病腎病（DN）是糖尿病發展至一定程度時較為嚴重的并發癥之一，由于其發病具有一定的隱蔽性，因此在發病初期患者生理并無明顯異常[1]，隨著病情發展可能導致腎衰竭等嚴重后果。因此早期的判定治療對患者恢復至關重要。臨床有效的診斷是制定有效治療方案的關鍵[2]。糖尿病患者病情發展后期其微血管會病變，同型半胱氨酸（Hcy）是通過內質網、氧化應激、致炎因子等各種途徑對血管內皮功能產生消極影響;胱抑素C（Cys-C）是反映腎小球濾過率變化的最為理想的內源性標志物;超敏C反應蛋白（hs-CRP）是炎性反應的有效標志物，當糖尿病患者內皮功能受損或者出現炎癥時其值明顯升高。該研究選取該院2018年10月—2019年10月收治的糖尿病患者共計100例作為研究組，同期選取100名健康的體檢者作為對照組，考察Cys-C、Hcy、hs-CRP聯合檢測對早期糖尿病腎損傷的診斷價值，現報道如下。