内科

目的探讨Cys C、Hcy和U-mAlb联合检测对早期糖尿病肾病的临床意义。方法收集糖尿病肾病（DN组）患者共32例，糖尿病无肾损害组（NRD）32例以及另选择同期来该院进行健康体检人员40例作为对照组，DN组患者根据病情分为早期DN组（EDN组）和临床DN组（CDN组），比较糖尿病肾病（DN）组、NRD组患者与对照组及早期DN（EDN）组与临床DN （CDN）组患者的Cys C、Hcy和U-mAlb水平。以Cys C＞1.09 mg/L，Hcy＞15 μmol/L，U-mAlb≥22 mg/L定为阳性，统计DN组，NRD组、对照组Cys C、Hcy和U-mAlb单项检测的阳性率及三者联合检测的阳性率。结果DN组患者的Cys C、Hcy、U-mAlb水平分别高于对照组，两组比较差异均有统计学意义（P均＜0.05）。EDN组患者的Cys C、Cys C、Hcy、U-mAlb水平分别低于CDN组，两组比较差异均有统计学意义（P均＜0.05）。NRD组患者的Cys C、Hcy和U-mAlb水平分别高于正常对照组，但分别低于EDN组、CDN组，差异均有统计学意义（P均＜0.05）。EDN组患者Cys C的阳性率为80.00%，Hcy阳性率为85.00%，U-mAlb阳性率为90.00%，分别与对照组比较差异均有统计学意义（P均＜0.01），三者联合检测阳性率为96.88%，且联合检测的阳性率显著高于单项检测阳性率。Cys C、Hcy和U-mAlb联合检测的灵敏度达96.88%。结论Cys C、Hcy和U-mAlb联合检测有利于早期糖尿病肾病的诊断和治疗。

ObjectiveTo investigate the clinical significance of combined Cys C, Hcy and U-mAlb tests in the early diabetic nephropathy. Methods32 patients with diabetic nephropathy（DN group）and 32 patients with diabetes without renal damage(NRD group) were enrolled ,and 40 cases health examination personnel were selected as control group,the 32 patients of DN group were divided into EDN group and CDN group according to the state of illness, the levels of Cys C, Hcy and U-mAlb among DN group, NRD group,control group were compared,and the above indexes were also compared between the EDN group and CDN group. The postive rate of Cys C, Hcy, and U-mAlb, as well as combined detection in the DN group, NRD group, and control group were calculated,the cutoff values of Cys C, Hcy and U-mAlb were1.09 mg/L,15 umol/L,22 mg/L,respectively. ResultsThe level of Cys C, Hcy and U-mAlb in DN group were significantly higher than those in control group(P＜0.05).The level of Cys C, Hcy and U-mAlb in EDN group were significantly lower than those in CDN group(P＜0.05).The level of Cys C, Hcy and U-mAlb in NRD group were significantly higher than those in control group,but lower than those in EDN group and CDN group,the difference was statistically significant(P＜0.05).The positive rate of Cys C,Hcy,U-mAlb were 80.00%,85.00%,90.00% in EDN group, respectively, were all significantly difference compared with the control group(P＜0.05),and combination of Cys C,Hcy,U-mAlb had a higher positiverate(96.88%) compared to single detection. The sensitivity of joint-detection of three was 96.88%. ConclusionsThe combined Cys C, Hcy and U-mAlb tests is helpful in the diagnosis and treatment of early diabetic nephropathy.