血清胱抑素C和尿微量白蛋白/肌酐比值联合检测对高血压早期肾损害的诊断价值

Diagnostic value of the combination of Cyst-C and urinary albumin/creatinine for hypertension early renal damage

目的探讨血清胱抑素(Cyst-C)、尿微量白蛋白/肌酐(UmAlb/UCr)对高血压患者早期肾损害的诊断价值。方法根据肾动态显像结果将85例原发性高血压患者分为早期肾功能损害组(A组)32例和单纯高血压组(B组)53例,并选取健康体检者50例为对照组,采用酶联免疫法测定各组Cyst-C、UmAlb/UCr、血清尿素氮(BUN)、血清肌酐(Scr)含量。结果与对照组相比,A组及B组Cyst-C、UmAlb/UCr水平显著升高,B组则高于A组,差异有统计学意义(P<0.05),而三组BUN、Scr水平比较差异无统计学意义(P>0.05)。随着高血压分级的增加,Cyst-C、UmAlb/UCr水平显著上升,其中Ⅲ级组患者显著高于Ⅰ级组及Ⅱ级组,差异有统计学意义(P<0.05)。Cyst-C灵敏性、特异性、准确性分别为81.6%、82.3%、69.2%,UmAlb/UCr灵敏性、特异性、准确性分别为84.5%、83.4%、76.9%,而UmAlb/UCr+Cyst-C灵敏性、特异性、准确性分别为93.2%、91.3%、92.3%。B组Cyst-C与UmAlb/UC联合检测阳性率显著高于单纯UmAlb/UCr或Cyst-C检测,差异有统计学意义(P<0.05)。结论 Cyst-C与UmAlb/UC联合检测有助于高血压患者早期肾损害的诊断。

Objective To investigate the early diagnosis value of the combination of Cyst-C and urinary albu- min/creatinine （UA/Cr） for hypertension early renal damage. Methods Eighty-five patients with essential hypertension were divided into early renal dysfunction group （A group）, （n=32） and hypertensive group （13 group）, （n=53）. Fifty cases of healthy persons were selected as the control group. The levels of Cyst-C, UmAIb/UCr, erum urea nitrogen （BUN） and serum ereatinine （Ser） of all groups were treated with enzyme-linked immunosorbent. Results The levels of Cyst-C, UmAIb/UCr of group A, group B were higher than those in control group （P〈0.05）, and the levels of BUN, Scr of in three groups showed no statistically significant difference. The levles of Cyst-C, UmAlb/UCr were significantly in- creased with the increase in blood pressure classification. The patients of class Ⅲ was significantly higher than those of Class I and Class II （P〈0.05）. The sensitivity, specificity, and accuracy of Cyst-C were 81.6%, 82.3%, 69.2%. The sen- sitivity, specificity, and accuracy of UmAlb/UCr were 84.5%, 83.4%, 76.9%. The sensitivity, specificity and accuracy of UmAlb/UCr＋Cyst-C were 93.2%, 91.3%, 92.3%. The positive rate of Cyst-C combined UmAIb/UCr of group B was higher than that of UmAIb/UCr or Cyst-C test （P〈0.05）. Conclustion Combination of Cyst-C and UmAIb/UC can de- tect early renal damage in patients with hypertension diagnosis.