李若淳,刘建红,王小星,曾明燕,苏艳丽,吴昌学
LI Ruochun,LIU Jianhong,WANG Xiaoxing,ZENG Mingyan,SU Yanli,WU Changxue

• 1:贵阳护理职业学院检验系
• 2:火箭军总医院
• 3:贵阳中医学院第二附属医院内分泌科
• 4:贵州医科大学分子生物学重点实验室

摘要(Abstract)：

目的:探究血清胱抑素C(Cys C)联合视黄醇结合蛋白(RBP)在早期糖尿病肾病诊断中的价值。方法:以90例不同病程的糖尿病患者为观察组,再根据患者病程又分为初诊组、<1年组、1~<6年组及6~12年组;选取同期体检的90例健康人员为对照组,采集2组受检者空腹8 h后的外周血清和晨尿,采用免疫比浊法测定血清Cys C和尿RBP含量;比较两组不同性别受检者、不同病程糖尿病患者血清Cys C、尿RBP的含量及阳性率。结果:观察组患者血清Cys C和尿RBP含量均显著高于对照组(P<0.05),对照组被检者未出现血清Cys C和尿RBP的阳性结果;观察组患者血清Cys C和尿RBP的阳性率分别为42.22%和71.11%,尿RBP的阳性率显著高于血清Cys C的阳性率(P<0.05);血清Cys C、尿RBP的含量和阳性率随着糖尿病病程的延长而逐渐增高,差异有统计学意义(P<0.05)。结论:糖尿病早期即可出现肾损伤,Cys C联合尿RBP检测可为肾脏损伤评估提供参考依据。
Objective: To investigate the diagnostic value of serum cystatin C combined with RBP on early diabetic kidney nephropathy. Methods: 90 cases of different degrees of diabetic patients were classified as the research group( further divided into primary diagonosed group, < 1 year gorup,1 ~< 6 year grop and 6 ~ 12 year group); selecting the same period 90 healthy people received medical examination as control group. Collecting peripheral serum and morning urine of both groups after 8 h fasting; adotping Immunoturbidimetry assay to detect serum cystatin C and urine RBP content. The difference between the two indexes of both groups were compared in terms of gender,serum cystatin C and urine RBP content of different degrees of diabetes and postive rate. Results: The serum cystatin C and urine RBP content in the observation group were higher than that of control group( P < 0. 05).Control group showed no postive result of serum cystatin C and urine RBP content. The test showed that the positive rate of serum cystatin C and urine RBP in the observation group was 42. 22% and 71.11% respectively,which the urine RBP positive rate was obviously higher than that of serum cystatin C( P < 0. 05). Serum cystatin C,urine RBP content and positive rate would increase as the course of diabetes prolonged,differences were statistically significant( P < 0. 05). Conclusion: There is kidney injury at early stage of diabetes,and serum cystatin C combined with urine RBP test provide reference for evaluation of renal injury.

关键词(KeyWords)： 血清胱抑素C;视黄醇结合蛋白;糖尿病;肾损伤;诊断
serum cystatin C;retinol binding protein;diabetes;kidney injury;diagnosis

Abstract:

Keywords:

基金项目(Foundation): 贵州省科技厅科技计划课题[黔科合LH字(2015)7330,黔科合LG字(2012)009]

作者(Author): 李若淳,刘建红,王小星,曾明燕,苏艳丽,吴昌学
LI Ruochun,LIU Jianhong,WANG Xiaoxing,ZENG Mingyan,SU Yanli,WU Changxue

DOI: 10.19367/j.cnki.1000-2707.2017.12.024

参考文献(References)：

• [1]翁建平.糖尿病领域的中国研究:新的时代正在到来[J].中国糖尿病杂志,2017(1):3-5.
• [2]Liang YI,Nephrology DO.Clinical analysis of combined test with Malb and urine sugar for diabetes early renal injury[J].Journal of Foshan University,2014(4):617-622.
• [3]肖文霞,陈小燕.糖尿病患者早期肾损伤的诊断进展[J].医学综述,2011(2):272-277.
• [4]王慧,于嘉屏.尿液四项指标联合检测对2型糖尿病患者早期肾损伤的诊断价值[J].国际检验医学杂志,2013(8):1025-1026.
• [5]Chen C,Jiuwen LI,Zhu Y.Diagnostic value of the combined detection of urine micro albumin and urine in early diabetic kidney injury[J].China Medicine&Pharmacy,2016(6):115-116.
• [6]韩日成,黄淑榆钱,张家明,等.血清胱抑素C对高血压、糖尿病患者早期肾损伤的诊断价值[J].辽宁医学院学报,2016(3):30-32.
• [7]刘玉英,殷和平,蒋璐.胱抑素C联合尿RBP检测对糖尿病患者早期肾损伤的诊断意义[J].海南医学院学报,2015(2):203-205.
• [8]周华强,白志杨,伍尚华.Cys C、RBP、BUN和Cr联合检测早期肾脏疾病的意义研究[J].中国当代医药,2016(23):129-131.
• [9]洪珊珊.ADA:糖尿病医学诊疗实用标准纲要—2012[J].中华糖尿病杂志,2012(2):81-90.
• [10]李永国.2型糖尿病患者血清维生素D水平与叶酸、同型半胱氨酸的相关性[J].贵州医科大学学报,2017(1):94-96.
• [11]王玉梅,刘红春,林新平,等.糖尿病患者早期肾损伤指标联合检测的临床价值[J].中国国误诊学杂志,2015(13):2466-2467.
• [12]崔淑芬.血尿生化指标联合检测对高血压和糖尿病患者早期肾损伤的诊断意义分析[J].中西医结合心血管病杂志,2016(5):26-27.
• [13]Wang YX.Urine sugar and urine trace albumin joint inspection value to the diagnosis of diabetes early renal damage analysis[J].Diabetes New World,2016(3):S376-S378.
• [14]康阳阳,刘章锁,刘东伟.中国成人慢性肾脏病患病率荟萃分析[J].中国实用内科杂志,201(9):785-789.
• [15]高飞.血清胱抑素C和β2微球蛋白在2型糖尿病肾病早期诊断中的价值[D].吉林:吉林大学,2013.
• [16]苏金刚,韩文占,樊锁兵,等.影响胰岛素治疗后1型糖尿病患者血糖达标的因素[J].贵州医科大学学报,2016(11):1353-1357.
• [17]叶珂杏,范良敏.2型糖尿病合并缺血性脑卒中临床特点及相关危险因素分析[J].贵州医科大学学报,2016(10):1231-1234.
• [18]周婉.视黄醇结合蛋白4与2型糖尿病大血管病变的关系及维生素D的干预作用[D].合肥:安徽医科大学,2016.
• [19]童于真,童南伟.中国成人2型糖尿病预防的专家共识精要[J].中国实用内科杂志,2014(07):671-677.
• [20]李非.视黄醇结合蛋白4促高胰岛素血症血管平滑肌增殖作用及机制的研究[D].长沙:中南大学,2013.

文章评论(Comment)：