陈纯旭

【摘要】 目的：研究早期糖尿病腎病患者采用血清淀粉样蛋白A、胱抑素C与尿白蛋白/肌酐比值联合检验方式在诊断中的价值与效果。方法：选择2018年3月-2019年3月笔者所在医院疑似早期糖尿病肾病患者71例，另选取同期50例笔者所在医院健康志愿者，全部受检者均行常规检验及联合检验，对比常规检验与联合检验准确性，并比较糖尿病肾病患者、糖尿病患者及健康志愿者联合检验相关指标。结果：71例患者确诊阳性率73.24%、阴性率26.76%。常规检验阳性率67.61%、阴性率32.39%;联合检验阳性率70.42%、阴性率29.58%;联合检验诊断结果的灵敏度、特异度、准确性均明显高于常规检验，且阴性预测值、阳性预测值明显较高（P<0.05）。糖尿病肾病患者血清淀粉样蛋白A、胱抑素C、尿白蛋白/肌酐比值均高于糖尿病患者、健康志愿者，且肾小球滤过率低于糖尿病患者、健康志愿者，差异均有统计学意义（P<0.05）。结论：早期糖尿病肾病患者通过血清淀粉样蛋白A、胱抑素C与尿白蛋白/肌酐比值联合检验准确性较高，可作为肾病检查的项目，应予以临床推广。

【关键词】 早期糖尿病肾病 血清淀粉样蛋白A 胱抑素C 尿白蛋白/肌酐比值

doi：10.14033/j.cnki.cfmr.2020.19.030 文献标识码 B 文章编号 1674-6805（2020）19-00-03

Diagnostic Value of Serum Amyloid A， Cystatin C and Urinary Albumin/Creatinine Ratio on the Early Detection of Diabetic Nephropathy/CHEN Chunxu. //Chinese and Foreign Medical Research， 2020， 18（19）： -77

[Abstract] Objective： To study the value and effect of the combined detection method of serum amyloid A， cystatin C and urinary albumin/creatinine ratio in patients with early diabetic nephropathy. Method： From March 2018 to March 2019， 71 patients with early suspected diabetic nephropathy in the authors hospital were selected， and 50 healthy volunteers from the authors hospital in the same period were selected. All the subjects were subjected to routine examination and joint examination， compared the accuracy of the routine examination and the joint examination， and compared the relevant indicators of the joint examination for patients with diabetic nephropathy， diabetes and healthy volunteers. Result： A total of 71 cases were diagnosed with a positive rate of 73.24% and a negative rate of 26.76%. The positive rate of routine examination was 67.61% and the negative rate was 32.39%; the positive rate of joint examination was 70.42% and the negative rate was 29.58%; the sensitivity， specificity and accuracy were significantly higher than those of routine examination， and the negative prediction value and positive predictive value were significantly higher （P<0.05）. Serum amyloid A， cystatin C， and urinary albumin/creatinine ratio were higher in diabetic patients and healthy volunteers， and the glomerular filtration rate was lower than in diabetic patients and healthy volunteers， the differences were statistically significant （P<0.05）. Conclusion： Patients with early diabetic nephropathy have higher accuracy through the joint examination of serum amyloid A， cystatin C and urinary albumin/creatinine ratio， which can be used as the items， and should be clinically promoted.

[Key words] Early diabetic nephropathy Serum amyloid A Cystatin C Urinary albumin/creatinine ratio

First-authors address： Nansha Hospital， Guangzhou First Peoples Hospital， Guangzhou 511458， China

肾病是糖尿病严重并发症之一，患者受到内分泌代谢异常的影响，其微血管发生病变，故造成其肾脏滤过能力下降，晚期阶段可造成患者尿毒症、肾功能衰竭等症状，严重危害患者生命安全[1-2]。本研究对早期糖尿病肾病诊断方式予以研究，给予患者血清淀粉样蛋白A、胱抑素C与尿白蛋白/肌酐比值联合检验，对其准确性及价值进行分析，现报告如下。

1 资料与方法

1.1 一般资料

选择2018年3月-2019年3月笔者所在医院疑似早期糖尿病肾病患者71例，同期在笔者所在医院选取50例健康志愿者。纳入标准：（1）患者均经生化检验确诊为糖尿病;（2）患者伴有不同程度的肾功能下降[3]。排除标准：（1）认知能力异常;（2）伴有急性肾脏类疾病;（3）短期内服用过影响肾功能的药物;（3）血液系统疾病[4]。……