目的：利用 ROC 曲线评价胱抑素 C（Cys C）诊断2型糖尿病肾损害的价值。方法120例2型糖尿病患者测量身高、体重和血尿素氮（BUN）、肌酐（SCr）、Cys C 水平及尿微量蛋白肌酐比值（ACR），利用 CKD-EPI 公式计算肾小球滤过率（eGFR），对 Cys C 与 eGFR 进行相关性分析，利用 ROC 曲线评估 Cys C 诊断2型糖尿病肾损害的价值，根据 Youden 指数确定诊断切点。对 eGFR 与 Cys C 诊断慢性肾损害的一致性进行 Kappa 检验。结果（1）eGFR ﹤60 ml/（min·1.73 m2）组患者的年龄、BUN、SCr、Cys C 和 ACR 水平均明显高于 eGFR≥60 ml/（min·1.73 m2）组；（2）Cys C 与 eGFR 之间呈负相关（ r ＝%Objective To evaluate the diagnostic value of cystatin C(Cys C)for kidney damage in patients with type 2 diabetes mellitus via receiver operating characteristic(ROC)curve. Methods 120 patients with type 2 diabetes mellitus were selected and the following data were collected:anthropometric indexes,blood urea nitrogen(BUN),serum creatine(SCr),serum Cys C and albuminuria creatine ratio(ACR);the estimated GFR(eGFR)was gained through CKD-EPI equation;a correlation analysis was made between Cys C and eGFR;ROC curve was applied to evaluate the diagnostic value of Cys C for kidney damage and cut-off point was determined by Youden index;Kappa test was performed to check the consistency of eGFR and Cys C in diagnosing chronic renal damage. Results (1)Age,BUN,SCr,Cys C and ACR of the patients in eGFR ﹤ 60 ml/(min·1. 73 m2 )group were in higher level than those of the patients in eGFR≥60 ml/(min·1. 73 m2 )group;(2)There existed a negative correlation between Cys C and eGFR (r = - 0. 808);(3)The area under ROC curve of the diagnosis of Cys C for chronic kidney damage was 0. 944(P = 0. 000)and the cut-off point was ﹥ 1. 18 mg/ L;the sensitivity was 82. 6% and the specificity was 93. 8% ;(4)The consistency between Cys C and eGFR was good with the Kappa value of 0. 709. Conclusions Elevated Cys C is a sensitive index for decreased GFR in patients with type 2 diabetes mellitus;Cys C ﹥ 1. 18 mg/ L can be taken as the diagnostic cut-off point of chronic kidney damage in patients with type 2 diabetes mellitus.
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