·糖尿病肾脏疾病

      【摘要】 目的 探讨老年T2DM患者血浆胱抑素C(Cys-C)水平变化与糖尿病慢性肾脏疾病(CKD)的相关性。 方法 选取老年T2DM患者(T2DM组)100例和健康体检者(NC)35名为研究对象，另根据UAlb/Cr结果将T2DM组分为<30 mg/24 h亚组32例，30～299 mg/24 h亚组35例和>300 mg/24 h亚组33例。测定各组血浆Cys-C水平和内生肌酐清除率(Ccr)。 结果 T2DM组和CKD各组血浆Cys-C水平均高于NC组(P<0.05)。CKD患者血浆Cys-C水平糖尿病病程、UAlb/Cr呈正相关(r=0.368、0.463，P<0.05)，与Ccr呈负相关(r=-0.802，P<0.05)。 结论 血浆Cys-C水平与老年T2DM患者肾功能损伤密切相关，可有效的评估CKD患者的肾功能。

　　【关键词】 胱抑素C;糖尿病慢性肾脏疾病;尿白蛋白;肌酐

　　【Abstract】 Objective To explore the correlation between the level of plasma cystatin C (Cys-C) and chronic kidney disease (CKD) in elderly patients with type 2 diabetes mellitus (T2DM). Methods 100 elderly patients with type 2 diabetes (T2DM group) and 35 healthy people (NC group) were selected. Based on the ratios of urinary albumin/creatinine (UAlb/Cr), T2DM patients were divided into three subgroups: UAlb/Cr<30 mg/24 h (n=32), 30～299 mg/24 h (n=35), and >300 mg/24 h (n=33). The level of plasma Cys-C was measured and endogenous creatinine clearance rate(Ccr) was calculated among different groups. ResultsThe plasma levels of Cys-C were higher in T2DM group and in each CKD subgroup than in NC group(P<0.05). The plasma levels of Cys-C was positively correlated with diabetic duration and UAlb/Cr(r=0.368,0.463，P<0.05), and negatively correlated with Ccr(r=-0.802，P<0.05). Conclusion The plasma Cys-C levels were closely related to impaired renal function in elderly patients with T2DM, which may be used to estimate the renal function in patients with diabetic nephropathy.

　　【Key words】Cystatin C(Cys-C); Diabetes mellitus, type 2; Chronic kindey disease(CKD); Urinary microalbumin(UAlb);Creatinine(Cr)