2020 年第 11 期 第 15 卷

血清胱抑素C与25-羟维生素D及同型半胱氨酸在糖尿病肾病患者中的临床应用价值

Clinical application value of serum cystain C, 25-hydroxy vitamin D and homocysteine in diabetic nephropathy patients

作者：王莹吴东红程瑶梁桂敏马晶

英文作者：Wang Ying Wu Donghong Cheng Yao Liang Guimin Ma Jing

单位：哈尔滨市第一医院内分泌科一病房150010

英文单位：The First Ward Department of Endocrinology the First Hospital of Harbin Harbin 150010 China

关键词：2型糖尿病；糖尿病肾病；胱抑素C；25-羟维生素D；同型半胱氨酸

英文关键词：Type2diabetesmellitus;Diabeticnephropathy;CystainC;25-hydroxyvitaminD;Homocysteine

• 摘要：

• 目的 分析血清胱抑素C、25-羟维生素D［25-(OH)D］、同型半胱氨酸（Hcy）在糖尿病肾病（DN）患者中的临床应用价值。方法 选取2018年7月至2020年1月于哈尔滨市第一医院就诊的2型糖尿病并发DN患者90例作为观察组，根据尿白蛋白排泄率水平分为正常蛋白尿组（30例）、早期肾病组（32例）、临床肾病组（28例）3个亚组，另外选取同期在本院健康体检者30例作为对照组。比较各组血清胱抑素C、25-(OH)D、Hcy水平。结果 正常蛋白尿组、早期肾病组和临床肾病组血清胱抑素C、Hcy水平均高于对照组［（0.69±0.28）、（0.92±0.31）、（1.37±0.36）mg/L比（0.43±0.25）mg/L，（10.7±3.2）、（13.7±3.8）、（17.0±4.3）μmol/L比（9.1±2.1）μmol/L］，25-（OH）D水平均低于对照组［（27.5±2.6）、（22.5±4.8）、（20.6±3.4）μg/L比（35.7±3.6）μg/L］，差异均有统计学意义（均P＜0.05）。临床肾病组血清胱抑素C、Hcy水平均高于早期肾病组和正常蛋白尿组，25-（OH）D水平低于早期肾病组和正常蛋白尿组；早期肾病组胱抑素C、Hcy水平均高于正常蛋白尿组，25-（OH）D水平低于正常蛋白尿组，差异均有统计学意义（均P＜0.05）。结论 血清胱抑素C、25-（OH）D及Hcy水平与DN的发病和进展密切相关，监测三者水平有利于及时采取措施阻止或延缓DN发生或发展。

• Objective To analyze the clinical application value of serum cystain C, 25-hydroxy vitamin D［25-(OH)D］ and homocysteine (Hcy) in diabetic nephropathy(DN) patients. Methods From July 2018 to January 2020，  90 patients in type 2 diabetes mellitus complicated with DN admitted to the First Hospital of Harbin were selected as the observation group. According to the urinary albumin excretion rate, they were divided into normal proteinuria group(30 cases), early nephropathy group(32 cases) and clinical nephropathy group(28 cases). In addition, 30 healthy people in our hospital during the same period were selected as the control group. The levels of cystatin C, 25-(OH)D and Hcy were compared among the four groups. Results The levels of cystatin C and Hcy in normal proteinuria group, early nephropathy group and clinical nephropathy group were higher and 25-(OH)D level was lower than those in control group［（0.69±0.28）, （0.92±0.31）, （1.37±0.36）mg/L vs （0.43±0.25）mg/L; （10.7±3.2）, （13.7±3.8）, （17.0±4.3）μmol/L vs （9.1±2.1）μmol/L；（27.5±2.6）, （22.5±4.8）, （20.6±3.4）μg/L vs （35.7±3.6）μg/L］, the differences were statistically significant(all P<0.05). The levels of cystatin C and Hcy in clinical nephropathy group were higher and 25-(OH)D level was lower than those in early nephropathy group and normal proteinuria group, and the levels of cystatin C and Hcy in early nephropathy group were higher and 25-(OH)D level was lower than those in normal proteinuria group, and the differences were statistically significant(all P<0.05). Conclusions The serum levels of cystain C, 25-(OH)D and Hcy are closely related to the occurrence and progression of DN. Monitoring the three indexes levels is conducive to take timely measures to prevent or delay DN occurrence or development.