血清胱抑素C论文：血清胱抑素C及同型半胱氨酸与2型糖尿病肾病的关系.doc

血清胱抑素C论文：血清胱抑素C及同型半胱氨酸与2型糖尿病肾病的关系【中文摘要】探讨血清胱抑素C和同型半胱氨酸水平与2型糖尿病肾病的关系。方法选择88例2型糖尿病患者作为观察组,根据Mogensen的分类标准分为3组:单纯糖尿病组;早期糖尿病组;临床糖尿病组。从健康体检者中选取20名志愿者作为对照组,分别通过免疫比浊法及酶法测定血清CysC、Hcy水平,并收集临床和实验室数据,将T2DM各组与正常对照组的结果进行比较研究,根据不同公式估算肾小球滤过率,并作受试者工作特征(ROC)曲线,了解血清CysC、Hcy与肾小球滤过功能的关系。结果1.观察组各组的血清CysC水平除单纯糖尿病组外均高于正常对照组(P1.05mg/L为标准作Ccr、eGFR1、eGFR2、eGFR3、eGFR4的ROC曲线,曲线下面积分别为0.754、0.781、0.781、0.793、0.796;以Hcy12.5umol/L为标准作Ccr、eGFR1、eGFR2、eGFR3、eGFR4的ROC曲线,曲线下面积分别为0.734、0.767、0.767、0.768、0.769。结论本研究表明:肾功能损害、长期的糖尿病病程和血糖控制不良是血清CysC和Hcy水平的主要影响因素,尤其是尿微量白蛋白的增加可以看着是血清CysC、Hcy水平增加的一个重要标记。血清CysC1.05mg/L和Hcy12.5umol/L可能是肾功能早期受损的临界值,由此界点判断肾小球滤过功能的ROC面积均具有较好的诊断价值,对慢性肾病早期(K-DOQI)判断具有较好的敏感性和特异性,其中以CysC1.05mg/L为界点的ROC面积为优。相比较而言,由国人研制出的新的肾小球滤过率计算公式更适合临床使用。【英文摘要】Objecyive: To investigate the relationship of serum cystatin C and homocysteine to Type two Diabetic Nephropathy.Methods: Eighty-eight cases of T2DM were choosed as a subject of the study, which was divided into three groups: simple diabetes mellitus(SDM), early diabetes mellitus(EDN) and clinical diabetes mellitus(CDN) according to Mogensens classification. Twenty healthy volunteers were selected as a control group , the serum level of cystatin C and homocysteine were measured by the methods of immunophrology method and enzyme. At the same time, we collected clinical and laboratory data ,compared the results of normal control group with T2DM groups respectively. We also estimated glomerular filtration rate (GFR) by various formulas and made receiver operating characteristic(ROC) curve to learn the relationship of serum cystatin C and homocystein to glomerular filtration rate.Results:1. The serum level of CysC was increased from control group to the CDN group, in which there were significant differences between these groups (p1.05mg/L for standard were 0.754、0.781、0.781、0.9793、0.796; the areas under the ROC curve of Ccr、eGFR1、eGFR2、eGFR3、eGFR4 to Hcy12.5umol/L for standard were 0.734、0.767、0.767、0.768、0.769.so the diagnostic value of CysC1.05mg/L to glomerular filtration rate was greater than the that of Hcy12.5umol/L.Conclusion: The study suggests that the injured renal glomerular function、long-term duration of diabetes and the poor control of glucose were the main influencing factors of serum cystatin C and homocysteine levels, especially the increase of microalbuminuria may be looked as a mark of serum cystatin C and homocysteine levels, increase. Serum CysC1.05mg/L and Hcy12.5umol/L maybe the critical value to early renal glomerular function damage, to judge glomerular filtration functions the areas under the ROC curve has a good diagnosis value by this bound point, it has better sensitivity and specificity to judge early chronic kidney disease (K-DOQI), and the area under under the ROC curve for boundary point of CysC 1.05 mg/L is superior. In comparison, the new glomerular filtration rate computation formula developed by compatriots is more suitable for clinical use.【关键词】血清胱抑素C 同型半胱氨酸 早期糖尿病肾病【英文关键词】Serum Cystatin C Homocysteine Ear