目的 分析生化检验指标在糖尿病肾病(DN)患者早期诊断中的应用效果.方法 选取 150 例DN患者作为研究组,另选取 150 例明确未患DN的健康体检者作为参考组.检测并对比两组生化指标[β2 微球蛋白(β2-MG)、同型半胱氨酸(Hcy)、C反应蛋白(CRP)、血清胱抑素C(CysC)、视黄醇结合蛋白(RBP)、α1-微球蛋白(α1-MG)、尿微量白蛋白(UALB)、游离脂肪酸(FFA)、血尿酸(UA)、尿蛋白(PRO)、血尿素氮(BUN)]和血糖指标[空腹血糖(FPG)、餐后 2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)].结果 参考组β2-MG、Hcy分别为(2.20±0.85)μg/L、(4.81±1.21)μmol/L,均低于研究组的(3.51±0.68)μg/L、(16.47±1.23)μmol/L,差异非常显著(P<0.05);参考组CRP、CysC分别为(1.78±0.15)、(0.18±0.74)mg/L,均低于研究组的(6.68±2.91)、(2.96±0.33)mg/L,差异非常显著(P<0.05);参考组RBP、α1-MG分别为(52.88±5.69)、(6.53±1.72)mg/L,均低于研究组的(77.97±6.92)、(20.76±2.65)mg/L,差异非常显著(P<0.05);参考组UALB、FFA分别为(5.34±1.24)mg/L、(604.31±55.23)μmol/L,均低于研究组的(46.47±5.11)mg/L、(1108.53±85.67)μmol/L,差异非常显著(P<0.05);参考组UA、PRO分别为(236.45±30.31)μmol/L、(40.21±4.93)mg/24 h,均低于研究组的(421.19±25.48)μmol/L、(85.87±11.17)mg/24 h,差异非常显著(P<0.05);参考组BUN为(5.83±1.14)mmol/L,低于研究组的(17.60±3.21)mmol/L,差异非常显著(P<0.05).参考组FPG(5.63±2.53)mmol/L、2 h PG(6.71±2.31)mmol/L、HbA1c(5.30±2.90)%均明显低于研究组的(10.57±4.67)mmol/L、(14.44±4.14)mmol/L、(8.11±1.21)%,差异非常显著(P<0.05).结论 DN患者的生化检验指标水平发生较大变动,因此可以根据生化指标水平进行早期诊断,值得临床推广应用.
Analysis of the effect of biochemical indicators in the early diagnosis of diabetes nephropathy
Objective To analyze the practical effect of biochemical indicators in the early diagnosis of diabetes nephropathy(DN).Methods 150 patients with DN were selected as the study group,and 150 healthy subjects who were confirmed not to have DN by physical examination at the same time were selected as the control group.Biochemical indicators[β2-microglobulin(β2-MG),homocysteine(Hcy),C-reactive protein(CRP),serum cystatin C(CysC),retinol-binding protein(RBP),α1-microglobulin(α1-MG),urinary albumin(UALB),free fatty acid(FFA),blood uric acid(UA),urine protein(PRO),blood urea nitrogen(BUN)]and blood glucose indicators[fasting plasma glucose(FPG),2 h postprandial glucose(2 h PG),glycosylated hemoglobin(HbA1c)]of the two groups were tested and compared.Results The β2-MG and Hcy were(2.20±0.85)μg/L and(4.81±1.21)μmol/L in the reference group,which were lower than(3.51±0.68)μg/L and(16.47±1.23)μmol/L in the study group,and the difference was highly significant(P<0.05).The CRP and CysC were(1.78±0.15)and(0.18±0.74)mg/L in the reference group,which were lower than(6.68±2.91)and(2.96±0.33)mg/L in the study group,and the differences were highly significant(P<0.05).The RBP and α1-MG were(52.88±5.69)and(6.53±1.72)mg/L in the reference group,which were lower than(77.97±6.92)and(20.76±2.65)mg/L in the study group,and the difference was highly significant(P<0.05).The UALB and FFA were(5.34±1.24)mg/L and(604.31±55.23)μmol/L in the reference group,which were lower than(46.47±5.11)mg/L and(1108.53±85.67)μmol/L in the study group,and the difference was highly significant(P<0.05).The UA and PRO were(236.45±30.31)μmol/L and(40.21±4.93)mg/24 h in the reference group,which were lower than(421.19±25.48)μmol/L and(85.87±11.17)mg/24 h in the study group,and the difference was highly significant(P<0.05).The BUN was(5.83±1.14)mmol/L in the reference group,which was lower than(17.60±3.21)mmol/L in the study group,and the difference was highly significant(P<0.05).The reference group had FPG of(5.63±2.53)mmol/L,2 h PG of(6.71±2.31)mmol/L,and HbA1c of(5.30±2.90)%,which were significantly lower than(10.57±4.67)mmol/L,(14.44±4.14)mmol/L,and(8.11±1.21)%in the study group,and the differences were highly significant(P<0.05).Conclusion The levels of biochemical indicators in patients with DN change greatly,and early diagnosis can be made according to the level of biochemical indicators,which is worthy of clinical application.
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