目的: 探讨联合检测血清胱抑素C( CysC) 、糖化血红蛋白( HbAlc) 及尿微量白蛋白( UmALB) 在诊断
2 型糖尿病早期肾损伤中的临床价值。方法: 选择2017－01 ～ 2017－06 在我院就诊的2 型糖尿病病人180 例，其
中单纯糖尿病病人60 例( B 组) 、早期肾损伤病人60 例( C 组) 、糖尿病肾病病人60 例( D 组) ，另选择同期在我
院体检健康者60 例( A 组) ，检测4 组的CysC、HbAlc 及UmALB 水平，并比较C 组病人3 项指标单独检测、联合
检测的阳性率及ＲOC 曲线下面积。结果: 检测结果表明C、D 组病人的Cys C、HbAlc、UmALB 水平均高于A、B
组( P＜0．05) ，且D 组各项指标明显高于C 组( P＜0．05) ; B 组病人与A 组比较UmALB 无明显差异( P＞0．05) ，而
Cys C、HbAlc 差异明显( P＜0．05) ; 3 项指标联合检测的阳性率为96．67%，均明显高于Cys C 的78．33%、HbAlc 的
76．67%和UmALB 的85．00%( P＜0．05) ; 联合检测的ＲOC 曲线下面积为0．912，大于Cys C、HbAlc、UmALB 各指标
的ＲOC 曲线下面积。结论: Cys C、HbAlc、UmALB 的水平变化均与糖尿病肾损伤有关，3 项指标联合检测可提高
阳性检出率，为病人病情严重程度的诊断和治疗提供参考。

Objective: To evaluate the clinical value of combined detection of CysC，HbAlc and
UmALB in the diagnosis of early renal injury in type 2 diabetes mellitus．Methods: 180 patients with
type 2 diabetes mellitus were selected from January 2017 to June－2017 in our hospital， including 60
patients with diabetes( group B) ，patients with early renal injury in 60 cases( C group) ，60 cases with
diabetic nephropathy( D group) ，selected in our hospital 60 cases of healthy subjects ( A group) ，4
groups were detected CysC，HbAlc and UmALB level，and compared the positive rate of C group were 3
indicators of separate and combined detection． Ｒesults: The results showed that the C group and D
group Cys C，HbAlc，UmALB higher than those in A group and B group( P＜0．05) ，and the indexes of
group D was significantly higher than that of C group( P＜0．05) ; there was no significant difference in
UmALB between group B and group A patients( P ＞ 0．05) ，Cys C，HbAlc difference obviously ( P ＜
0．05) ; the positive rate of combined detection of 3 indexes of 96．67%were significantly higher than that
in Cys C 78．33%，HbAlc 76．67%，UmALB 85%( P＜0．05) ．The area under the ＲOC curve of joint detection
was 0．912，greater than the area under the ＲOC curve of Cys，C，HbAlc and UmALB．Conclusion:
The changes of Cys，HbAlc and UmALB levels are related to the renal injury in diabetes mellitus，
and the combined detection of the 3 indexes can improve the positive detection rate and provide a reference
for the diagnosis and treatment of the disease severity of the patients with C．

Ｒ587．2