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Objective: diabetic kidney disease has become an important cause of end-stage renal disease in China, it is very important to the early diagnosis and timely treatment. Currently there are more commonly used in the evaluation of renal function indicators defects. This study determined the diabetic patients with serum cystatin C (Cys C), β2 microglobulin, creatinine, urea nitrogen, and 24-hour urinary albumin excretion in some patients using 99mTc-DTPA clearance rate calculated glomerular filtration rate (GFR ), using cystatin C and creatinine-based formulas were calculated GFR, to explore serum cystatin C, and so far they calculated GFR β2 microglobulin in the evaluation of diabetic kidney damage clinical significance. Method: 1. Cases collected research object visits to the Alexander homes diabetes patients signed an informed consent. The inclusion criteria in line released by the WHO in 1999 diabetes diagnosis and classification criteria, including patients with hypertension, to be the law of medication and blood pressure is stable for more than half a year. Exclude stress, thyroid disease, cancer, rheumatic disease, liver disease, kidney disease, immunosuppressive drugs, glucocorticoids and limb absence. 2 parameters were measured The ① record general information, including gender, age, height, weight, duration of disease, blood pressure, body mass index BMI BMI = weight / height (kg/m2) ② patients in the dietary patterns of life, sacrificing 24h urine and Statistical total mix of 10ml send detection of urinary albumin excretion amount (UAE) ③ 10h after the fasting venous blood 4ml, the next morning, and immediately inspected measured cystatin C, creatinine, β2 microglobulin , urea nitrogen, glycosylated hemoglobin ④ random sample of 40 cases, hematuria specimens collected next day fasting state, by 8-10ml/kg weight drinking water, 20min after intravenous injection of 99mTc-DTPA 1mci/1ml respectively 2h 4h after contralateral cubital vein for blood 5ml, the centrifugation supernatant 1 ml of 99mTc-GFR calculated instrument collected data. Were calculated Cys-GFR, simplified MDRD-GFR (MDRD-GFR used in this article to indicate) the MDRD-GFR = 1.86 × Cr-1.154 × -2.03 × 0.742 (female), age (Cr units mg / dl) Cys-GFR = 86.7/Cys C-4.2 (the the Cys C units mg / L). According to Mogensen staging all the object of study is divided into three groups the normoalbuminuria group NC (UAE lt; 30mg/24h), microalbuminuria Group DN1 (UAE 30-300mg/24h), albuminuria group the DN2 (UAE gt; 300mg/24h), comparing serum markers difference between the groups; compare the MDRD-GFR, Cys-GFR with 99mTc-GFR ; comparison of Cys C, β2-microglobulin, creatinine area under the ROC curve. Results: 1. Microalbuminuria serum Cys C levels significantly higher than normal albuminuria group, the difference was statistically significant (P lt; 0.05); β2-microglobulin, creatinine, blood urea nitrogen, no difference between the two groups statistically significant. The macroalbuminuria group serum markers were higher than the microalbuminuria group, the difference was statistically significant (P lt; 0.01). 2. MDRD-GFR, Cys-GFR with 99mTc-GFR showed a significant correlation, correlation coefficients were 0.7,0,837 (P lt; 0.01), Cys-GFR better than the MDRD-GFR. 3.Cys C, creatinine, β2-microglobulin in the area under the ROC curve were 0.897,0.723,0.877, the Cys C area, β2-microglobulin followed, creatinine minimum. Conclusion: In diabetic kidney disease, microalbuminuria period, serum Cys C has been significantly increased compared to creatinine, urea nitrogen, β2-microglobulin were more sensitive to reflect early kidney damage. , Serum Cys C levels gradually increased with the severity of kidney damage. 2.Cys C, β2-microglobulin, reflected in the overall sensitivity and specificity glomerular filtration function and accuracy are superior to creatinine. 3. Cys-GFR MDRD-GFR with 99mTc-GFR better than, therefore Cys C calculated glomerular filtration rate can more accurately reflect the glomerular filtration rate.
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