Objective To explore the changes of urinary neutrophil gelatinase associated lipocalin( NCAL) and serum cystatin C ( CYS-C ) in type 2 diabetes mellitus (T2DM) patients, and their diagnostic value on diabetic nephrathy (DN). Methods Seventy cases with T2DM were selected. The patients were divided into 3 groups according to the urinary albumin excretion rate (UAER) , which includes normal albuminuria group (n = 20 ) , micro-albuminuria group (n = 25 ) and clinical nephrosis group (n =25). Twenty healthy people without nephrosis were selected as control group. NCAL level was detected by ELJSA. CYS-C level was detected by immune rate than scattering turbidity method. The relationship between urinary NCAL,CYS-C and glomerular filtration rate(CFR)was analyzed. Results The urinary NCAL level in normal albuminuria group was higher than that in control group(P <0.05). Compared with control group,in micro-albuminuria group and clinical nephrosis group,GFR was decreased,NGAL and CYS-C levels were increased(/'<0.01). There was statistical significance in GFR.NGA and CYS-C between micro-albuminuria group and clinical nephrosis group(P <0.01). The urinary NGAL and CYS-C levels had negative correlate to GFR in T2DM patients(r, = -0.312,r2 = -0.412;P<0.05). Conclusion There has good correlation between urinary NGAL and GFR in T2DM patients. It provides a guide for early diagnosis of DN to detect urinary NGAL and serum CYS-C.%目的 探讨2型糖尿病(T2DM)患者尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和血清胱抑素C( CYS-C)的改变及其对糖尿病肾病(DN)的诊断价值.方法 选择T2DM患者70例,根据尿清蛋白排泄率(UAER)分为正常清蛋白尿组20例、微量清蛋白尿组25例和临床肾病组25例,并选取同期20例非肾病健康体检者作为对照组.应用酶联免疫吸附试验(ELISA)检测患者尿NGAL水平,应用免疫速率散射比浊法检测血清CYS-C水平,分析尿NGAL及血清CYS-C水平与肾小球滤过率(GFR)之间的关系.结果 正常清蛋白尿组的尿NGAL较对照组明显升高,差别有统计学意义(P＜0.05).微量清蛋白尿组和临床肾病组的GFR、尿NGAL、血清CYS-C与对照组比较差别均有统计学意义(P＜0.01).临床肾病组的GFR、尿NGAL、血清CYS-C与微量清蛋白尿组比较差别有统计学意义(P＜0.01).糖尿病患者尿NGAL和血清CYS-C水平与GFR均呈负相关(r1=-0.312,r2=-0.412,P＜0.05).结论 T2DM患者尿NGAL与GFR有较好的相关性,测定尿NGAL和血清CYS-C可为早期诊断DN提供参考依据.
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