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目的探讨联合检测血清同型半胱氨酸(Hcy)、胱抑素C(Cys C)、尿微量白蛋白(mALB)在糖尿病肾病早期诊断中的应用价值。方法分别检测单纯糖尿病组、早期糖尿病肾病组、临床糖尿病肾病组和正常对照组血清Cys C、Hcy和尿mALB含量。结果糖尿病各组的Hcy、Cys C、尿mALB的水平及阳性率均显著高于对照组(P<0.01),早期糖尿病肾病组三项指标水平显著高于单纯糖尿病组(P<0.05),临床糖尿病肾病组三项指标水平显著高于早期糖尿病肾病组(P<0.05)。三指标联合检测糖尿病肾病阳性率达96.25%,明显高于单项检测。结论血清Hcy、Cys C和尿mALB是糖尿病肾病早期诊断的敏感指标,水平与肾脏损伤程度相关,三指标联合检测有助于糖尿病肾病的早期诊断。
Objective To investigate the value of combined detection of serum homocysteine (Hcy), cystatin C (Cys C) and urinary microalbumin (mALB) in the early diagnosis of diabetic nephropathy. Methods Serum levels of Cys C, Hcy and urinary mALB were measured in patients with simple diabetes mellitus, early diabetic nephropathy, clinical diabetic nephropathy and normal controls respectively. Results The levels of Hcy, Cys C, urinary mALB and the positive rate of urine in each group were significantly higher than those in the control group (P <0.01). The levels of three indicators in the early diabetic nephropathy group were significantly higher than those in the simple diabetic group (P <0.05) The levels of three indicators in diabetic nephropathy group were significantly higher than those in early diabetic nephropathy group (P <0.05). The three indicators of diabetic nephropathy combined detection rate of 96.25%, significantly higher than the single test. Conclusions Serum Hcy, Cys C and urinary mALB are sensitive indicators of early diagnosis of diabetic nephropathy. The levels are related to the degree of renal injury. Combined detection of three indexes is helpful for the early diagnosis of diabetic nephropathy.