血清胱抑素C对老年高血压病肾功能损害诊治的临床意义

Clinical Significance of Serum Cystatin C in Treating Elderly Hypertensive Renal Damage

目的探讨血清胱抑素C(CysC)在老年高血压病肾功能损害中的应用价值。方法检测高血压患者的血清CysC、肌酐(Cr)及尿酸(UA)水平。比较不同Cr水平组患者CysC和UA水平的差异。结果不同Cr水平组患者的CysC水平间差异明显,经两两比较,差异均有统计学意义(P<0.05);Cr水平正常组与其他3组比较,UA水平间差异均有统计学意义(P<0.05),其他3组UA水平两两比较差异无统计学意义(P>0.05)。Cr水平正常组中,CysC正常者35例,CysC升高者20例,其Cr水平间差异有统计学意义(P<0.05)。通过控制血压、改善肾血流等保肾治疗,Cr、CysC水平均较治疗前明显下降(P<0.05)。结论血清CysC是反映高血压早期肾功能损害的内源性敏感指标,在早期诊断高血压肾损伤、评价肾功能不全程度及治疗效果判定方面具有重要的临床价值。

Objective To study the application value of serum cystatin C （CysC） in hypertensive patients with im- paired renal function. Methods Tested the levels of serum CysC, Creatinine （Cr） and uric acid （UA） and made a compari- son between CysC and UA in patients with different Cr. Results The difference of CysC in patients with different Cr was signifi-cant （ P 〈 0. 05 ） ; the difference of UA between the patients with normal Cr and the other three groups was significant （ P 〈 0. 05） ; the difference of UA between the other three groups was not significant （P 〉 0. 05 ）. In the patients with normal Cr, there were 35 patients with normal CysC, 20 patients with CysC increasing, the difference between them was also significant （P〈 0. 05）. After renal protective treatment such as controlling blood pressure, improving renal blood flow, the levels of Cr and CysC all had an obvious decrease than before （P 〈 0. 05 ）. Conclusion A sensitive endogenous indicator for early hypertensive renal impairment, serum CysC plays a very important role in early diagnosis of hypertensive renal injury, assessment of renal dys- function and judgment of therapeutic effect.