| Diabetes mellitus，DM is a Metabolic disorder caused by the mutual actions ofGenetic and environmental factors. Its feature is groups of chronic hyperglycemia，the Pathogenesis is insulin resistance and insulin secretion deficiency，among themType2Diabetes mellitus,T2DM is the main type which thread the health of human,nowadays it has become the third Non-communicable diseases after angionosis andtumour。Acute and Chronic microvascular complications seriously thread humanlives and cause significant harm and heavy burden to the normal lives of society ofhuman. It has become a worldwide public health problem in need of solution and hasgotten lots of attention. Dibaectinephorpahty-DN is one of common seriousmicrovascular complications of DM, as well as the main reasons to cause disabilityand death to diabetic. A large number of clinical data shows the interventiontreatment to DN in early period can converse the states of illness, if it develops tolate middle, then the states of illness will get worse and can’t be conversed, so theearly diagnosis and treatment are very important.Aim：The evaluation of renal function commonly had been used nowadayssexists relative defections this research measuresC(CysC)、(β2-MG)、（Scr）、(BUN)and24hours（Malb）of diabetic，observe the connection of each index and thedevelopment of the states of illness, discuss the application valus of CysC、β2－MGin the diagnosis of Type2Diabetes mellitus. Through the study the connectionbetween the indirect reflection of CysC,β2－MG, Scr、BUN、Malb and glomerulus,study whether the2index above can be the sensitive index of the early diagnosis ofdiabetic nephropathy.Methods： Subjects of study: The113patients who are in hospital and see thedoctors in outpatient department in our hospital from Sep.2011to Oct.2012, and who have be diagnosed as diabetic according to the publication of’Diabetes diagnosisand classification standard′of WHO in1999. Male:61cases, female:52cases, age:between34and75，average age:（55．3±11．9）。 Normal control group:40cases,male:22cases, female:18cases, age from33to69, average age（52．4±10.7），all of them are defined to the healthy subjects by the physical examination, noserious liver, kidney or other organs diseases, no hypertension, no diabetes mellitusor other endocrine system disease，the index of their blood glucose, blood fat， liverfunction and so on are normal. There is no significant difference of gender and agebetween2groups（P＞0．05），possess the comparability. The study subjects haveno immune system disorders of connective tissue, no infection or renal lesionscaused by tumor, no diabetic ketosis acidosis、 no acute complications ofhyperosmolar state or heart failure and other complications. On the basis of theexperimental objective, the study split the diabetes mellitus into3groups accordingto UAER,A: Simple diabetes group UAER<30mg/24h;B: Early diabetic nephropathygroup UAER reaches30~300mg/24h。C: Clinical diabetic nephropathy groupUAER≥300mg／24h。At the same time select40cases were defined to be healthyby the medical examination center of our hospital as the comparable group, requiretheir medical history specifically and record their general information: age, gender,height, disease duration, weigh and so on. Calculate their weight index BMI，BMI=weight/heigh2.(kg/m2)，patients should keep24hours urine under regulardietary lives,take out10ml after mixed and send the samples to text UAE，at thesame time stick to the regulation that before taking the blood samples, the patientsshould jejunitas after10PM. The next morning,，Venous blood was collected understerile operation by nurse and send the samples for text immediately. Using immuneturbidimetry to measure the patients’ Cys-C， using chemiluminescence tomeasureβ2-MG and Radioimmunoassay to measure Malb）、enzymic method tomeasure potency of Scr、BUN，using SPSS17．0to do the statistical process of allthe test data.The results of measurement data showed by(x±S)，the measurementdata between2groups showed by t, P<0．05there is Statistical difference, the comparative analysis of the relationships between2factors by pearson, when P＜0.05is defined that there is statistical significance,P＜0.01stands for distinctdifference of statistical significance。Compare whether there is difference of thechange level of CysC、B2-MG、 Scr、BUN and Malb among patients. Study thePositive number of CysC、B2-MG、Scr、BUN、and Malb of the study subjects amongthe groups in different periods of diabetic nephropathy，and calculate the positiverate then do the comparison, and compare the dependency of CysC,β2-MG andclinical index.Result:（1）Group A: there is no significant difference between the index ofgroups and control group, there is no statistical significance（P>0.05），the level ofCys C、β2－MG and Urinary albumin of group B and group A raise significantlycompare with control group(P＜0.05), the differences have statistical significance,and in group B the change of Cys C and β2－MG is more significant than Scr、BUN and Malb，the difference have statistical significance(P＜0.05)，There is nosignificant change of Scr and BUN in group B compare with group A,（P>0.05）, sothere is no statistical significance，every index has significance in group C comparewith group A, B and control group, there is statistical significance (P＜0.01)。Asthe extension of the disease duration, and exacerbation of the disease,Cys C and β2–MG increase significantly (P＜0.05)。（2）In group B, the positive rate of CysC and β2-MG can reach around50%，however the positive rate of Scr and BUN isvery low, the difference has statistical significance, there is no significant differencebetween group A and control group, in group C, the positive rate of all clinical indexhave no significant difference. Therefore, the relevance ratio of Cys C and β2–MGis high in early diabetic nephropathy group, more sensitive and Scr and BUN（3）Theanalysis of dependency：The analytic result of Cys C and all clinical indexshows:Cysc positively related to disease duration,SBP、B2-MG,Scr、BUN、Malb、HbAlc1, there is no significant relates with gender, age,BMI and DBP。The analyticresult of relater of β2–MG and all clinical index shows：β2-MG positively relatestodisease duration、SBP、Cysc、Scr、BUN、Malb and HbAlc1, there is no significant relates with gender, age,BMI and DBP。Overall,Cys C has the best relates withβ2–MG, Scr、BUN and Malb，can indirectly reflex the condition of glomerularfiltration，can indirectly evaluate the degree of impairment of renal functionConclusion:1、Cys C and β2-MG enchancedsignificantly in the early period ofdiabetic nephropathy, they are more sensitive than Scr and BUN、they can reliablyreflect the change of Glomerular filtration function in early period of diabeticnephropathy, Both Cysc and B2microglobulin can be used as index to observe thedevelopment of diabetes mellitus。2、in early period of diabetic nephropathy, theCys C and β2-MG have relatively high positive relevance ratio，significantly higherthan positive relevance ratio of Scr and BUN.It has certain application value for theearly screening and evaluation of the early period renal damage in diabeticnephropathy3、CysC、B2-MG,Scr、BUN and Malb are positively related，has imitaterelationship with it, Hence, in clinical, the diabetic those are found their Scr andMalb increase, but Scr and BUN do not increase should be given high attention,Weshoud give effective treatment,has the important value of control and prognosis ofdiabetic nephropathy. |
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