血清胱抑素c论文：血清胱抑素c及同型半胱氨酸与2型糖尿病肾病的关系

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血清胱抑素C论文：血清胱抑素C及同型半胱氨酸与2型糖尿病肾病的关系【中文摘要】 探讨血清胱抑素C和同型半胱氨酸水平与2型糖尿病肾病的关系。方法选择88例2型糖尿病患者作为观察组,根据Mogensen的分类标准分为3组:单纯糖尿病组;早期糖尿病组;临床糖尿病组。从健康体检者中选取20名志愿者作为对照组,分别通过免疫比浊法及酶法测定血清CysC、Hcy水平,并收集临床和实验室数据,将T2DM各组与正常对照组的结果进行比较研究,根据不同公式估算肾小球滤过率,并作受试者工作特征(ROC)曲线,了解血清CysC、Hcy与肾小球滤过功能的关系。结果1.观察组各组的血清CysC水平除单纯糖尿病组外均高于正常对照组(P1.05mg/L为标准作Ccr、eGFR1、eGFR2、eGFR3、eGFR4的ROC曲线,曲线下面积分别为0.754、0.781、0.781、0.793、0.796;以Hcy>12.5umol/L为标准作Ccr、eGFR1、eGFR2、eGFR3、eGFR4的ROC曲线,曲线下面积分别为0.734、0.767、0.767、0.768、0.769。结论本研究表明:肾功能损害、长期的糖尿病病程和血糖控制不良是血清CysC和Hcy水平的主要影响因素,尤其是尿微量白蛋白的增加可以看着是血清CysC、Hcy水平增加的一个重要标记。血清CysC>1.05mg/L和Hcy>12.5umol/L可能是肾功能早期受损的临界值,由此界点判断肾小球滤过功能的ROC面积均具有较好的诊断价值,对慢性肾病早期(K-DOQI)判断具有较好的敏感性和特异性,其中以CysC>1.05mg/L为界点的ROC面积为优。相比较而言,由国人研制出的新的肾小球滤过率计算公式更适合临床使用。【英文摘要】Objecyive:ToinvestigatetherelationshipofserumcystatinCandhomocysteinetoTypetwoDiabeticNephropathy.Methods:Eighty-eightcasesofT2DMwerechoosedasasubjectofthestudy,whichwasdividedintothreegroups:simplediabetesmellitus(SDM),earlydiabetesmellitus(EDN)andclinicaldiabetesmellitus(CDN)accordingtoMogensen’sclassification.Twentyhealthyvolunteerswereselectedasacontrolgroup,theserumlevelofcystatinCandhomocysteineweremeasuredbythemethodsofimmunophrologymethodandenzyme.Atthesametime,wecollectedclinicalandlaboratorydata,comparedtheresultsofnormalcontrolgroupwithT2DMgroupsrespectively.Wealsoestimatedglomerularfiltrationrate(GFR)byvariousformulasandmadereceiveroperatingcharacteristic(ROC)curvetolearntherelationshipofserumcystatinCandhomocysteintoglomerularfiltrationrate.Results:1.TheserumlevelofCysCwasincreasedfromcontrolgrouptotheCDNgroup,inwhichthereweresignificantdifferencesbetweenthesegroups(p1.05mg/Lforstandardwere0.754、0.781、0.781、0.9793、0.796;theareasundertheROCcurveofCcr、eGFR1、eGFR2、eGFR3、eGFR4toHcy>12.5umol/Lforstandardwere0.734、0.767、0.767、0.768、0.769.sothediagnosticvalue ofCysC>1.05mg/LtoglomerularfiltrationratewasgreaterthanthethatofHcy>12.5umol/L.Conclusion:Thestudysuggeststhattheinjuredrenalglomerularfunction、long-termdurationofdiabetesandthepoorcontrolofglucosewerethemaininfluencingfactorsofserumcystatinCandhomocysteinelevels,especiallytheincreaseofmicroalbuminuriamaybelookedasamarkofserumcystatinCandhomocysteinelevels,increase.SerumCysC>1.05mg/LandHcy>12.5umol/Lmaybethecriticalvaluetoearlyrenalglomerularfunctiondamage,tojudgeglomerularfiltrationfunctionstheareasundertheROCcurvehasagooddiagnosisvaluebythisboundpoint,ithasbettersensitivityandspecificitytojudgeearlychronickidneydisease(K-DOQI),andtheareaunderundertheROCcurveforboundarypointofCysC>1.05mg/Lissuperior.Incomparison,thenewglomerularfiltrationratecomputationformuladevelopedbycompatriotsismoresuitableforclinicaluse.【关键词】血清胱抑素C同型半胱氨酸早期糖尿病肾病【英文关键词】SerumCystatinCHomocysteineEarlyDiabeticNephropathy【目录】 血清胱抑素C及同型半胱氨酸与2型糖尿病肾病的关系英文缩略词3-4中文摘要4-6英文摘要6-7引言8-10材料与方法10-15结果15-23讨论23-28结论28-29参考文献29-33致谢33-34综述34-41参考文献38-41攻读学位期间取得的成果41-43