D二聚体 D-二聚体、胱抑素C在早期糖尿病肾病诊断中的临床价值

　　【摘要】 目的 探讨D-二聚体（D-D）、血清胱抑素C(Cys C)在早期糖尿病肾病(DN) 诊治中的临床价值。方法 将94例2型糖尿病（T2DM）患者，根据24小时尿微量清蛋白排泄率(UAER)分为单纯糖尿病组(SDM组)30例，早期糖尿病肾病组（EDN组）32例，糖尿病肾病组(CDN组) 32例；另选30名健康体检者作为对照组，分别检测各组中血D-D、血清Cys C，对各组检测结果进行比较，并进行相关分析。结果 四组血清D-D、Cys C、UAER比较差异均有统计学意义（P＜0.01），进一步两两比较发现，EDN组和CDN组的血清D-D、Cys C、UAER均显著高于SDM组和对照组（P＜0.01），CDN组的血清D-D、Cys C、UAER又显著高于EDN组（P＜0.01）。采用直线回归分析D-D、Cys C与UAER的关系，结果D-D、Cys C与UAER均成正相关，相关系数分别为0.392和0.786。结论 血浆D-D、血清Cys C水平随着DN的发展而逐渐升高,两者在早期糖尿病肾病的诊断中有重要临床价值。
　　【关键词】 D-二聚体；胱抑素C；糖尿病肾病
　　文章编号：1003-1383(2012)04-0486-03
　　中图分类号：R 587.2 文献标识码：A
　　doi:10.3969/j.issn.1003-1383.2012.04.013
　　
　　Clinical value of D dimer and cystatin C in the diagnosis of early diabetic nephropathy
　　WANG Deqin,YAN Chong,HAN Xiaojun,SU Ruting,YANG Xiaohua
　　(Department of Nephrology and Endocrinology, the Hai"an Hospital Affiliatedto Nantong University,Nantong 226600,Jiangsu)
　　【Abstract】 Objective To investigate the clinical application value of D dimer （D-D）and cystatin C（Cys C）in the early diagnosis and treatment of diabetic nephropathy(DN).
　　Methods 94 cases with type 2 diabetes mellitus (T2DM) were divided into 3 groups according to their 24-hour urinary albumin excretion rates of trace.These groups included the simple diabetic mellitus (SDM) group (30 cases),early diabetic nephropathy(EDN)group(32 cases),and clinical diabetic nephropathy (CDN) group(32 cases).And 30 healthy people were selected as the control group.The D-D and Cys C of each group were detected.he data was compared and given correlation analysis.
　　Results There were statistical difference in levels of D-D,CysC,UAER of the four groups(P＜0.01).Further comparison showed that levels of D-D and Cys C of the EDN group and the CDN group were obviously higher than those of the SDM group and the control group（P＜0.01）.And levels of all these indexes of the CDN group were higher than those of the EDN group（P＜0.01）.Analysis of linear regression revealed that D-D,CysC and UAER were positively correlated and their correlation coefficients were 392 and 0.786.
　　Conclusion Plasma D-D,serum Cys C levels of patients gradually increase with the development of DN.They have important clinical value in the early diagnosis of diabetic nephropathy.
　　【Key words】 D-dimer；cystatin C；diabetic nephropathy
　　糖尿病肾病(Diabetic nephropathy，DN)是糖尿病全身性微血管并发症之一，也是目前我国慢性肾衰竭主要病因之一，随着人们生活水平的提高，糖尿病的发病率逐年增加，糖尿病肾病是糖尿病患者主要死亡原因之一,尽早诊断及治疗可延缓和降低糖尿病演变为肾衰竭的概率。笔者通过对94例早期2型糖尿病患者D-二聚体（D-D）、血清胱抑素C(cystatin C，Cys C)及其他生化指标的检测，进一步探讨D-D及Cys C在DN早期诊断及治疗中的临床意义。