尿微量白蛋白/尿肌酐、血清胱抑素C、血清β2-微球蛋白在高血压肾病早期诊断中的价值

The Value of Urinary Albumin/Creatinine, Serum Cystatin C and Serum β2-microglobulin in the early Diagnosis of hypertensive Nephropathy

目的研讨尿微量白蛋白/尿肌酐(UACR)、血清胱抑素C(Cys-C)、血清β2-微球蛋白(β2-MG)再诊断早期高血压肾病中的价值。方法选择新乡医学院第三附属医院2022年1月至2022年12月收入的82例高血压患者,依照有无合并肾病分为高血压无明确肾病组40例和高血压肾病组42例,再选择42例同期入院的健康体检者为对照组。检测所有研究对象UACR、Cys-C、β2-MG水平,对比三组检测结果。结果高血压肾病组UACR、Cys-C、β2-MG水平均高于高血压无明确肾病组和对照组,高血压无明确肾病组UACR、Cys-C、β2-MG水平较对照组高,差异具有统计学意义(P<0.05);不同肾脏受损分级高血压患者的UACR、Cys-C、β2-MG水平存在差异,差异具有统计学意义(P<0.05),随着肾脏受损分级的增高,UACR、Cys-C、β2-MG水平也在不断增高;UACR联合Cys-C联合β2-MG检测高血压肾病阳性率97.62%,高于UACR、Cys-C、β2-MG单一检测的85.71%、80.95%、76.19%,差异具有统计学意义(P<0.05);UACR、Cys-C、β2-MG值均与肾脏受损程度呈正相关性(P<0.05)。结论UACR、Cys-C、β2-MG联合检测可辅助诊断早期高血压肾病,在临床应将三项指标联合应用,但还需结合病史和临床表现综合诊断。

Objective To study the value of urinary albumin/creatinine(UACR),serum cystatin C(Cys-C),and serumβ2-Microglobulin(β2-MG)in the early diagnosing of hypertensive nephropathy.Methods A total of 82 hypertensive patients admitted to Third Affiliated Hospital of Xinxiang Medical College from January 2022 to December 2022 were selected.They were divided into two groups based on the presence or absence of nephropathy:40 patients with hypertension and 42 patients with hypertension nephropathy.Additionally,42 healthy individuals who underwent physical examinations during the same period were selected as the control group.The levels of UACR,Cys-C andβ2-MG were measured in all subjects.Results The levels of UACR,Cys-C andβ2-MG in the hypertensive nephropathy group were higher than those in the hypertensive group and the control group.The level of UACR,Cys-C andβ2-MG in the hypertensive group was higher than that of the control group,and the difference was statistically significant(P<0.05);The levels of UACR,Cys-C andβ2-MG were significantly different in patients with different grades of renal damage(P<0.05).The levels of UACR,Cys-C andβ2-MG were also increased with the increase of renal damage grades.The positive rate of UACR combined with Cys-C andβ2-MG was 97.62%,which was higher than that of UACR,Cys-C andβ2-MG alone(85.71%,80.95%,76.19%),the difference was statistically significant(P<0.05).The levels of UACR,Cys-C andβ2-MG were positively correlated with the degree of renal damage(P<0.05).Conclusion The combined detection of UACR,Cys-C andβ2-MG may be helpful in the diagnosis of early hypertensive nephropathy.The three indexes should be combined in clinical practice,but it is necessary to make a comprehensive diagnosis in combination with the history and clinical manifestations.