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目的探讨血清胱抑素(CysC)、视黄醇结合蛋白(RBP)及脑钠肽(BNP)联合检测对2型糖尿病(T2DM)早期肾病的临床诊断价值。方法 112例T2DM患者按尿蛋白定量分为两组,每组56例。DM1组24-h尿蛋白量<150mg,DM2组24-h尿蛋白量150～300mg;另选非糖尿病56例作为对照(C组)。测定三组血清CysC、RBP及BNP。结果 DM1组、DM2组血清CysC、RBP和BNP均明显高于C组(P<0.01);DM2组血清CysC、RBP和BNP明显高于DMl组(P<0.01)。在DMl组和DM2组,三项指标联合检测优于单项检测。结论 CysC、RBP及BNP均是T2DM早期肾病的敏感指标,三项联合检测有助于早期诊断糖尿病肾病。
Objective To investigate the clinical value of combined detection of serum cystatin C, retinol binding protein (RBP) and brain natriuretic peptide (BNP) in the early diagnosis of type 2 diabetes mellitus (T2DM) with early nephropathy. Methods One hundred and twelve patients with T2DM were divided into two groups according to urinary protein, 56 cases in each group. Urine protein of 24-h in DM1 group was less than 150mg, urine protein of 24-h in DM2 group was 150-300mg, and 56 other non-diabetic patients were selected as control group. Three groups of serum CysC, RBP and BNP were measured. Results Serum CysC, RBP and BNP in DM1 and DM2 groups were significantly higher than those in C group (P <0.01). Serum CysC, RBP and BNP in DM2 group were significantly higher than those in DM1 group (P <0.01). In the DMl group and the DM2 group, the combined detection of the three indicators was superior to the single detection. Conclusions CysC, RBP and BNP are both sensitive indicators of early stage renal disease in T2DM. The three combined tests are helpful for the early diagnosis of diabetic nephropathy.