肾功能指标联检在高血压早期肾损害诊断中的应用

Application of Renal Function Index in the Diagnosis of Early Renal Damage in Essential Hypertension

目的:探讨尿β2-微球蛋白(β2-MG)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)和血清胱抑素C(Cys C)三项肾功能指标联合检测对高血压肾损害早期的临床诊断价值。方法:将106例高血压患者以微量蛋白尿呈阴性、阳性分为A、B两组,A组56例,B组50例,另选择56名健康体检者作为对照组,分别检测血清肌酐(Scr)、血清Cys C、尿β2-MG和尿NAG四项指标。结果:三组Scr检测值比较无显著性差异(P>0.05);A组和B组Cys C、β2-MG、NAG三项检测值均明显高于对照组(P<0.01),而B组又明显高于A组(P<0.01)。Cys C、β2-MG、NAG三项指标联检对高血压早期肾损害的阳性诊断率达87.7%,明显高于单项检测及二项联检阳性率(P<0.01)。结论:Cys C、β2-MG、NAG三项指标联检能较早地反映高血压肾损害程度,对高血压早期肾损害的诊断具较高的敏感性。

Objective： To investigate clinical diagnosis value of combined detection of three renal function markers such as urine β2 - microglobulin （ β2 - MG）, urinary N - aeetyl beta - D - Glucosaminidase （NAG） and serum cystatin C （Cys C） on early hypertensive renal damage. Methods： According to microalbuminuria＇s negative and positive, 106 eases of hypertensive patients were divided into two groups. 56 cases were in group A, and another 50 eases were in group B. In addition, we chose 56 healthy people as control group, four indexes were detected, the se- rum creatinine （Set） , of serum Cys C, urinary β2 - MG and urine NAG. Results： there was no significant differ- ence between the three groups in respect of Scr detection value （ P 〉 0. 05） ; detection values of Cys C, β2 - MG, NAG in group A and group B were significantly higher than those in the control group （ P 〈 0. 01 ）, and detection values of Cys C, β2 - MG, NAG in group B was significantly higher than that of group A （ P 〈0. 01 ） . If joint detection of indexes of Cys C, β2 - MG, NAG were used, the essential hypertension rate of the positive index for diagnosis of early renal damage reached 87. 7%, which was significantly higher than that of single detection and two levels （P 〈0. 01） . Conclusions： Joint detection of indexes of Cys, C, β2 -MG, NAG can reflect hypertensive renal damage earlier, which has higher sensitivity to diagnosis of earlier renal damage in essential hypertension.