目的 探讨胱抑素C(CysC)对评价2型糖尿病早期肾病治疗疗效的价值.方法 选择96例初诊2型糖尿病早期肾病患者进行强化全面达标治疗6个月,将58例血糖、血脂、血压、体质指数(BMI)4项指标全部恢复正常者归为全面达标组;将36例部分指标恢复正常者归为部分达标组,2例患者退出研究.以同期门诊体检健康者30例为对照组.比较3个组入选当时及6个月后血压、血脂、BMI、糖化血红蛋白(HbA1c)、血清肌酐(SCr)、24 h尿微量清蛋白(24 h-MAlb)、肾小球滤过率(GFR)及CysC水平以及CysC降幅与上述指标降幅的关系.结果 全面达标组CysC、24 h-MAlb较治疗前和部分达标组下降明显,但仍高于对照组,差异均有统计学意义(P＜0.01).且CysC降幅与SBP、HbA1c、LDL-C、24 h-MAlb降幅呈正相关,与GFR降幅呈负相关(P＜0.05).结论 CysC可作为糖尿病早期肾病治疗疗效的评价指标.%Objective To investigate the values of CysC in the efficacy evaluation of early kidney disease in type 2 diabetes. Methods A total of 96 cases of newly diagnosed type 2 diabetes with early nephropathy were selected and then underwent comprehensive standard treatment for 6 months. The 58 cases with blood glucose, blood fat, blood pressure, and body mass index recovered were defined as the up - to-standard group while the 36 cases with the indices partially recovered defined as the partially up - to - standarded group. For the constrol group, 30 healthy out - patients underwent physical examination during the the same period. Two patients withdrew from the study. Blood pressure, blood fat, body mass index ( BMI ), glycated hemoglobin ( HbA,c ), serum creatinine ( SCr ), 24 h urine trace ( 24 h - MAlb ), Glomerular filtration rate ( GFR ) and CysC level were compared between the two groups both at enrollment and 6 months later with the relationship between CYSs decline and decline of the above indicators studied. Results CysC, 24 h - MAlb in the up - to - standard group were remarkably lower than in the partially up -to -standard group, in the control group and in the same group before treatment ( P < 0. 01 ) . The range of fall of CysC had a significant positive correlation with those of SBP, HbA,c, LDL - C, and 24 h - MAlb and a negative correlation with GFR ( P < 0. 05 ) . Conclusion CysC may serve as an evaluating indicator of the efficacy of early kidney disease in type 2 diabetes.
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