| Background:Diabetic nephropathy(DibaectiNephorpahty,DN)as the most common microvascular disease in patients with diabetes complications,and is the common pathological factors in patients with type 2 diabetes death and disability,it is the main reason of diabetic patients with renal failure.Clinical on the pathogenesis of diabetic nephropathy is unclear,so we can find with detection sensitivity indicators of a laboratory with disease diagnosis value not only in the early stage of diabetic nephropathy,and its dynamic performance and the development of the disease correlation has been the focus of attention of the medical profession.Objective:Measured by the biochemical indexes of the selected population,analysis indicators of changes in different patients with diabetic nephropathy(DN)associated with clinical disease progression,and a detailed analysis of serum cystatin C and retinol binding protein and urine beta 2-microspheres on egg early clinical diagnostic significance of diabetic nephropathy disease.Methods:A total of 120 patients over 60 years old and diagnosed with diabetes were admitted to the geriatric ward of Inner Mongolia Baotou Steel Hospital from January 2014 to December 2015.The 24h urine retention and total urine output were recorded,The urine samples of patients fully shake the 10ml sent to the laboratory to test urinary albumin excretion rate(UAER)of patients,each patient was grouped according to the test results of urinary albumin excretion rate in size will be selected,and given treatment differences in different groups.Group A(simple diabetes group):UAER,30 mg/24h;group B(early diabetic nephropathy group:30 mg/24h<UAER≤ 300 mg/24h);group C(DN group):UAER>300 mg/24h;selected to our hospital physical examination results showed normal physical examination in 40 cases as D group(control group).All patients were fasting on the basis of the determination of serum cystatin C(ScysC),serum retinol binding protein(RBP),urinary beta 2-microglobulin(β2-MG),urinary albumin(UMA),urea nitrogen(BUN),24 hour urinary albumin(Malb),serum creatinine(Scr)and other indicators.Results:The corresponding comparison a,B two groups of indicators showed CysC,RBP,Scr,beta 2-MG,BUN comparison was not statistically significant,but the CysC,RBP,changes of β2-MG index contrast D group was higher than Scr,changes in BUN index comparison group D to be large.Statistics of the two groups of patients with the indicators CysC,RBP,β2-MG,compared with statistical significance,a,B,two groups of patients,researchers,CysC,REP,β2-MG,compared to statistical significance;Two groups of researchers,CysC,RBP,β2-MG,Scr,and BUN were statistically significant.The comparison of CysC,RBP,β 2-MG,Scr and BUN between the two groups is statistically significant;Compared with the corresponding C CysC,RBP,Scr,β2-MG,BUN indicators and group D,group A and group B showed that each index of the corresponding were statistically significant.Comparative examination of various types of indicators in each set of positive detection rate of researchers found in Group D,in addition to BUN index positive rate of 2.5%other outer positive detection rates of the indicators are 0,butoxy group found in normal physical examination CysC population,RBP,β2-MG,Scr,BUN detect almost all negative indicators in patients with diabetes in the early Group a CysC,RBP,β2-MG,Scr,BUN detection indicators show positive,and CysC,RBP,β2-MG,Scr three indicators contrast Scr,BUN three indicators of positive detection rate should be significantly higher than the rate in patients;Compared with group B and group A were CysC,RBP,β2-MG,Scr,BUN positive detection rate of detection index,CysC,B group RBP,β2-MG,Scr,BUN positive detection rate of detection index is greater than 55%;Both Scr and BUN tested positive for less than 15%,and the CysC,RBP,and β2-MG were more sensitive than Scr and BUN in early diagnosis of group b and diabetic nephropathy.Analysis of the correlation between the indexes visible CysC,RBP,β2-MG was a positive correlation between two of three indicators,and the three indicators with the patient’s gender,age,body mass index(bmi)and diastolic blood pressure basic no correlation,and in patients with systolic blood pressure,urine trace albumin,course of diseases,Scr,BUN,various indexes were positively correlated.Among them,comprehensive reference CysC,RBP,β2-MG,Scr,BUN indicators can be used as an indirect index to evaluate the damage of diabetic renal functionConclusion:Through the determination of CysC,RBP and β2-MG in diabetic patients,it can be used as an evaluation index of glomerular function in diabetic patients,and the sensitivity of these three indexes to determine glomerular function is far Significantly in Scr,BUN two indicators,And can be used as a clinical diagnostic basis for early diabetic nephropathy,Among the patients who were clinically diagnosed with diabetic nephropathy,CysC,RBP,β2-MG were more positive in clinical trial diagnosis,And its clinical test in the diagnosis of positive rate than Scr,BUN clinical test in the diagnosis of positive higher rate,It is proved that CysC,RBP and β2-MG can be used as a dynamic clinical indicator for the development of disease in diabetic nephropathy patients. |
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