联合检测五项生化指标在慢性肾脏病诊断中的意义

The Value of the Combined Tests of Five Biochemical Indicators for Diagnosis of Chronic Kidney Disease

目的:了解尿素(Urea)、肌酐(Cr)、尿酸(UA)、β2-微球蛋白(β2-MG)和胱抑素C(Cystatin C,Cys-C)五项肾功能指标在慢性肾脏病(CKD)诊断中的意义。方法:使用全自动生化分析仪对137例CKD患者和50例正常人血清中五项肾功能指标进行检测,检测结果进行统计学分析。结果:CKD疾患组血清中Urea、Cr、UA、β2-MG和Cys-C浓度与正常对照组比较,差异均有统计学意义(P<0.01)。在诊断CKD中,各单项指标敏感度以β2-MG和Cys-C为最高,为83.9%和91.2%,在糖尿病肾病、高血压肾病的诊断中阳性率达62.5%、69%和79.5%、86.5%。组合检测较单项指标敏感度和准确度高,各种组合检测中,以联合检测五项肾功能指标组敏感度和准确度最高,达100%和97.9%。结论:多指标联合检测CKD方法简便,敏感性、特异性和准确度高,对CKD预报具有重要价值,适合在临床工作中推广使用。

Objective To study the value of the combined tests of the five renal function biochemical indicators including ureanitroger （Urea）, creatinine （Cr）, uric acid （ UA ）, β2-microglobulin （β2-MG）, cystatin C （ Cys-C ） for the diagnosis of chronic kidney disease（CKD）. Methods Serum of 137 CKD patients and 50 healthy cases are examined with auto biochemical analyzer, and analyzed statistically. Results The difference of serum content between CKD patients and normal control had statistical significance（P 〈 0.01 ）. The sensitivity of β2-MG for CKD diagnosis was 83.9%, and that of Cys-C was 91.2%, they were the highest ratio among the five tests. In the diagnosis for diabetic nephropathy and hypertension nephropathy, the positive rate were 62.5% ,69% ,79.5% and 86.5%. The sensitivity and accuracy for diagnosis with combined tests were higher than single test. Furthermore, in all kinds of combined detections, the five-biochemical indicators combined tests for diagnosis had the highest sensitivity of 100% and accuracy of 97.9%. Conclusion Allied tests of five biochemical indicators for diagnosis of CKD are available, and it＇ s sensitivity, specificity and accuracy for diagnosis is high. As a result, the allied tests have significant value in the diagnosis of CKD, and it will be suitable to popularize in clinical work.