| Objective:To explore the laboratory indexes of diabetic renal injury in type2cystatin (serum CysC), glomerular filtration rate (GFR), serum creatinine(SCr), α l-MG,β2-MG, creatinine clearance rate (Ccr) and blood urea nitrogen (BUN) in Diabetic Nephropathy Clinical Application value.Methods:120cases of diabetic nephropathy patients as the research object,at the same time, according to the research object of urinary albumin excretion is different, the120patients were divided into four groups, namely, normal albuminuria (group DM1), microalbuminuria (DM2) group, and clinical proteinuria group (DM3), serum cystatin four groups in blood is detected by blood (serum CysC), glomerular filtration rate (GFR), serumcreatinine (SCr), α1-MG and β2-MG are important indexes of renal function and the reaction of creatinine clearance rate (Ccr) and urinary albumin (Ualb) and other indicators, the relationship between four groups of diabetic nephropathy patients, whether there is a difference, at the same time, laboratory indexes and evaluation on early renal damage in type2diabetes research and analysis. Results1. Four groups of subjects are in the number of cases, the proportion of men and women, age, course of disease, waist hip ratio (WHR), body mass index(BMI), systolic blood pressure, diastolic blood pressure have no significant difference, etc., show that the choice of grouping research object does not exist biased phenomenon, with comparabl2. DM1group of2glomerular filtration rate is significantly higher than the control group, DM2group of glomerular filtration rate is significantly lower than the control group, but the urinary albumin excretion rate in DM2group is significantly higher than that of the control group data index, glomerular filtration rate of DM3group is lower than that of control group, but the group of urinary protein excretion rate (UAE), serum creatinine (SCr), and blood urea nitrogen (BUN) and other three are significantly higher than control group,and all above the difference is statistically significant (P<0.05);3. Glomerular filtration rate (GFR) and serum SCr, Cys C, and the BUN three index are negatively correlated(r=-0.573,-0.818and-0.526), glomerul arfiltration rate (GFR) correlation coefficient R and serum Cys C maximum,represents the correlation between the two most closely;4. BUN and SCr likelihood ratio (+LR) is lower than that of serum CysCpositive likelihood ratio (+LR), and the negative likelihood ratio, negative likelihood ratio of serum Cys C (LR) value than the negative likelihood.BUN and SCr ratio is much lower, the above results show that, in the authenticityreaction detection results, BUN and SCr can not be like the serum Cys C thatcan accurately is the reaction results. In three, the serum Cys C which can best reflect the results of authenticity;5. In the DM1study group, positive rate of β2-MG in urine were significantly lower than that of urinary Cys C (P=0.007); the positive rate of (β2-MG in urine is significantly lower than the positive rate of urinary a1-MG (P=0.007).In the DM2study group, positive rate of β2-MG in urine are signifi-cantly lower than that of urinary Cys C (P=0.016); the positive rate of β2-MG in urine are significantly lower than that of urinary Cys C (P=0.038). In the DM3study group, the difference between the positive rate, positive rate of β2-MG in urine of urine Cys and urine C in α1-MG three are not statistically significant (P=0.178,0.235)Conclusion:The correlation of diabetic nephropathy patients’ serum CysC and urinary protein excretion rate, Glomerular filtration rate (GFR) have a significant difference.The serum CysC>1.05mg/L as a critical value of the early stage of diabetic nephropathy in patients with impaired renal function, through the critical value to the evaluation of renal function of ROC area showed clinical value is the assessment and diagnosis of good, with high specificity and sensitivity in the early diagnosis of diabetic nephropathy. |
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