目的 探讨尿单核细胞趋化蛋白1(UMCP-1)和血清胱抑素C(CysC)在糖尿病肾病(DN)早期诊断中的临床意义.方法 依据尿清蛋白排泄率(UAER)将137例2型糖尿病(T2DM)患者分为3组:DN临床组(46例)、DN早期组(48例)及DN前期组(43例),另选择体检健康者50例作为对照组.分别检测各组受检者的UMCP-1[以UMCP-1/尿肌酐(UCr)表示,即UMCP-1/UCr]、血清CysC、尿微量清蛋白(UMA)和血肌酐(SCr)水平.结果 DN前期组患者UMCP-1、血清CysC水平较对照组显著升高,差异有统计学意义(P＜0.05);DN早期组、DN临床组患者UMCP-1、血清CysC和UMA水平分别与DN前期组、对照组比较亦显著升高,差异有统计学意义(P＜0.01);DN临床组患者SCr水平显著高于对照组和DN前期组,差异有统计学意义(P＜0.01).相关分析显示,UMCP-1/UCr和CysC均与UMA呈正相关(P＜0.05).结论 UMCP-1联合血清CysC检测有助于DN的早期诊断.%Objective To explore the clinical significance of urinary monocyte chemoattractant protein -1 ( UMCP-1 ) and serum cystatin C ( CysC ) in the early diagnosis of diabetic nephropathy. Methods Based on urinary albumin excretion rate ( UAER ), 137 patients with type 2 diabetes were divided into three groups: diabetic nephropathy group ( clinical group,46 cases ), early group of diabetic nephropathy ( early group, 48 cases ), and pre - diabetic nephropathy group ( pre - stage group, 43 cases ) . Fifty healthy subjects were enrolled as controls. UMCP -1 [ in the form of UMCP -1/urinary creatinine ( UMCP - 1/UCr ) ], serum CysC, microalbuminuria ( UMA ) and serum creatinine ( SCr ) concentrations were detected in all groups. Results Levels of UMCP -1 and serum CysC were significantly higher in the pre - stage group than in the control group ( P < 0. 05 ) . Levels of UMCP - 1, serum CysC and UMA were higher in the early group and the clinical group than in the pre -stage group and the control group ( P <0. 01 ) . Relation analysis revealed that both UMCP - 1/UCr and CysC were positively correlated with UMA ( P < 0. 05 ) . Conclusion The combination of urinary UMCP - 1 and serum CysC detection is helpful to the early diagnosis of diabetic nephropathy.
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