摘要：目的 探讨糖尿病肾微血管病变患者血清胱抑素C（cystatin C, CysC）、视黄醇结合蛋白（retinol binding protein, RBP）及尿N-乙酰-β-D氨基葡萄糖苷酶（N-acetyl beta-D Glucosaminidase , NAG）的水平变化与糖尿病肾病病变程度的关系。方法 本研究选取30例2型糖尿病肾病患者（尿微量白蛋白<14.29mg/L）作为A组、选取30例2型糖尿病肾病患者（尿微量白蛋白≥14.29mg/L）作为B组、30例2型糖尿病肾病引发尿毒症患者作为C组、30例体检正常研究对象作为D组，比较四组患者血清中CysC、RBP、NAG的差异。结果 A、B、C、D四组研究对象的CysC、RBP及尿NAG水平差异均具有统计学意义（P<0.01）；组间比较，A、B、C组 CysC、RBP及尿NAG与D组比较均显著的高于D组，差异均具有统计学意义（P <0.05）；A、B组患者的CysC、RBP及尿NAG与C组比较显著低于C组，差异具有统计学意义（P <0.05）；A组患者的CysC、RBP及尿NAG与B组比较显著低于B组，差异具有统计学意义（P <0.05）。 结论 糖尿病肾病患者随着病变程度不断加重，CysC、RBP及尿NAG水平呈明显的上升趋势。

Abstract: Objective To explore the relationship between the levels of serum cystatin C (CysC), retinol binding protein (RBP) and urinary N- acetyl beta -D Glucosaminidase (NAG) changes and the severity of diabetic nephropathy in diabetic patients with renal microvascular lesions. Methods 30 cases of type 2 diabetic patients with nephropathy (urinary albumin<14.29mg/L) as group A, 30 cases of type 2 diabetic patients with nephropathy (urinary albumin≥ 14.29mg/L) as group B, 30 cases of type 2 diabetic nephropathy uremia patients as group C and 30 normal subjects as group D were involved in this study. The serum levels of CysC, RBP and urine NAG in all groups were determined. Results There were significantly difference on the levels of serum CysC, RBP and urine NAG between four groups (P <0.01). The levels of serum CysC, RBP and urine NAG in group A, group B and group C were significantly higher than those in group D (P <0.05). The levels of serum CysC, RBP and urine NAG in group A and group B were significantly lower than those in group C (P <0.05). The levels of serum CysC, RBP and urine NAG in group A were significantly lower than that of in group B (P <0.05). Conclusion The levels of serum CysC, RBP and urinary NAG in diabetic patients with renal microvascular lesions show an increase tendency as the severity of diabetic nephropathy increasing.