血清胱抑素C对原发性高血压早期肾损伤的诊断价值

Clinical diagnostic value of serum cystatin C in early renal impairment of patient with essential hypertension

目的探讨血清胱抑素C(Cys C)在原发性高血压(EH)早期肾损害监测的临床应用价值,为临床诊断治疗提供理论依据。方法选择原发性高血压病人104例为研究对象,正常人群50例为对照组。所有入选者均测定血清Cys C、血清肌酐(Scr)、血清尿素氮(BUN)和尿肌酐(Ucr),算出肌酐清除率(CCR)并按身高、体质量校正。以简化的肾病膳食改良实验(MDRD)公式计算出的肾小球滤过率(GFR)作为诊断标准,比较Cys C、Scr、BUN和CCR与GFR的相关性。结果原发性高血压病各组与健康对照组比较,血清Cys C水平差异均有统计学意义(P<0.05)。相关系数的绝对值显示Cys C最高,Cys C与GFR的相关性高于Scr、BUN、CCR与GFR的相关性。结论 Cys C优于其它GFR内源性指标,在常规检测Scr、BUN和CCR的基础上,联合应用Cys C可更早发现原发性高血压病患者肾功能的改变。

Objective To discuss the clinical value of cystatin C in monitoring the early renal impairment derived from essential hyperten- sive and provide theoretical insight for clinical diagnosis and treatment. Methods Serum cystatin C, Scr, Bun and Ucr were detected in 104 es- sential hypertensive patients and 50 healthy persons. Creatinine clearance rate （Ccr） was calculated and corrected according to the stature and body weight. Glomerular filtration rate （GFR） was determined by the simplified modification of diet in renal disease （MDRD） formula as the diag- nostic criteria. The correlation of cystatin C, Scr, Bun, Ccr with GRF was compared. Results Compared with control group, serum cystatin C of patients with essential hypentesion showed statistical significance （ P 〈 O. 05 ）. The absolute value of correlation coefficient of cystatin C was the greatest. The correlation of cystatin C with GFR was greater than that of Ser, Ccr, and Bun. Conclusion Seurm cystatin C is superior to other endogenous GFR indicators. Combined with Scr, Ccr and Bun, detection of cystatin C may monitor the early renal impairment in patient with essential hypertension.