血清Cys—C、Cr、Urea在糖尿病及高血压肾病早期的诊断中的应用价值

陈思梅　刘莹　曾少云

【摘要】 目的：探討血清胱抑素（Cys-C）、肌酐（Cr）和尿素（Urea）在糖尿病及高血压肾病早期诊断中的临床意义。方法：选取2015年1月-2016年12月本院收治的240例2型糖尿病和220例高血压患者进行分组，分别检测患者血清Cys-C、Cr、Urea水平，并对结果进行比较分析。结果：（1）在2型糖尿病诊断中，糖尿病肾病终末期组和糖尿病肾病早期组的Cys-C水平，均明显高于健康对照组和单纯糖尿病组，比较差异均有统计学意义（P<0.05）；单纯糖尿病组和糖尿病肾病早期组的Cr和Urea水平比较，差异均无统计学意义（P>0.05）。（2）在高血压肾病的诊断中，高血压肾病终末期组和早期高血压肾病组的Cys-C水平，均明显高于健康对照组和单纯高血压组，比较差异均有统计学意义（P<0.05）；单纯高血压组和早期高血压肾病组的Cr和Urea水平比较，差异均无统计学意义（P>0.05）。结论：Cys-C在糖尿病肾病及高血压肾病病情严重程度上具有更显著的敏感性，且Cys-C在糖尿病肾病和高血压肾病的早期诊断中有较高临床应用价值。

【关键词】 胱抑素； 血清肌酐； 血清尿素； 糖尿病肾病； 高血压肾病； 早期肾损害

Value of Serum Cys-C，Cr，Urea in the Early Diagnosis of Diabetic and Hypertensive Nephropathy/CHEN Simei，LIU Ying，ZENG Shaoyun，et al.//Medical Innovation of China，2018，15（16）：0-023

【Abstract】 Objective：To investigate the clinical significance of serum cystatin C （Cys-C），creatinine （Cr） and urea （Urea） in the early diagnosis of diabetic and hypertensive nephropathy.Method：A total of 240 patients with type 2 diabetes and 220 patients with hypertension admitted in our hospital from January 2015 to December 2016 were selected，they were divided into groups and their levels of serum Cys-C，Cr，and Urea were measured.The results were compared and analyzed.Result：In the diagnosis of type 2 diabetes，the levels of Cys-C in the end-stage group of diabetic nephropathy and early stage of diabetic nephropathy were significantly higher than those in the healthy control group and the simple diabetes group，the differences were statistically significant（P<0.05）.There were no significant differences in the levels of Cr and Urea between the simple diabetes group and early stage of diabetic nephropathy group（P>0.05）.In the diagnosis of hypertensive nephropathy，the levels of Cys-C in the end-stage of hypertensive nephropathy group and the early stage of hypertensive nephropathy group were significantly higher than those in the healthy control group and the simple hypertension group，the differences were statistically significant（P<0.05）.There were no significant difference in the levels of Cr and Urea between the simple hypertension group and the early stage of hypertensive nephropathy（P>0.05）.Conclusion：Cys-C has more significant sensitivity in the severity of diabetic nephropathy and hypertensive nephropathy， and it has a higher clinical value in the early diagnosis of diabetic nephropathy and hypertensive nephropathy.

【Key words】 Cystatin； Serum creatinine； Serum urea； Diabetic nephropathy； Hypertensive nephropathy； Early renal damage

First-authors address：Lechang Traditional Chinese Medicine Hospital，Lechang 512200，China

doi：10.3969/j.issn.1674-4985.2018.16.006

糖尿病属于一种高发的慢性全身性疾病，据普查结果显示，我国的糖尿病患者，将赶超印度成为糖尿病第一大国[1-4]。糖尿病患者中有20%～40%的患者最终会发展成糖尿病肾病[5-6]。高血压病是临床常见病及多发病，高血压肾损害是高血压病最常见的并发症之一，患者可从肾小管的损害逐渐发展到肾功能衰竭，由于早期缺乏明显的特征表现和体征。且患者在就诊时肾功能的损伤已开始进入尿毒症阶段，主要是由于肾脏微血管病变，从而引起肾脏功能病变的慢性并发症之一，也是糖尿病、高血压致死致残的主要原因之一[7]。……