尿酸和血清胱抑素C对高血压肾损害早期诊断的预测价值

目的：探讨血尿酸和血清胱抑素C对高血压肾损害的早期诊断价值。方法前瞻性纳入原发性高血压患者151例，根据是否并发肾损害，将患者分为单纯高血压组（I组）和高血压肾损害组（Ⅱ组），采用全自动生化分析仪同时测定血清尿酸、肌酐和尿素氮，免疫透射比浊法测定血清胱抑素C含量，并与健康体检者（对照组）相关指标作比较，并进行相关分析，评价血尿酸和血清胱抑素C对高血压肾损害早期诊断的价值。结果 I组、Ⅱ组血尿酸和血清胱抑素C的阳性率明显高于对照组（P〈0.01）。同组患者血尿酸和血清胱抑素C的阳性率明显高于其血尿素和血肌酐阳性率（P〈0.01）。此外，高血压患者血尿酸和血清胱抑素C的升高早于血尿素和血肌酐。结论血尿酸和血清胱抑素C是反映高血压早期肾功能损害的敏感指标，其敏感度高于血尿素和血肌酐，在诊断高血压早期肾损害方面有重要的临床价值。

Objective To determine whether blood uric acid and serum cystatin C were early biomarkers of renal damage secondary to hypertension. Methods A total of 151 eligible patients were enrolled in this prospective study. According to whether the rate of kidney damage,the patients were divided into hypertension group（group I）and hypertensive renal injury group（groupⅡ）. The concentration of blood uric acid、creatinine and urea nitrogen were measured by automatic chemisty analyze and the concentration of serum cystatin C was measured by immune transmission nephelometry by immune turbidimetry method,Results compared with that in control group and were retrospectively analyzed. Results The levels blood uric acid and serum cystatin C-positive rate of group I and groupⅡwere significantly higher than the control group（P〈0.01）.However,the levels of blood uric acid and serum cystatin C-positive rate in hypertensive patients were significantly higher than the blood urea and serum creatinine-positive rate（P〈0.01）.In addition,the blood uric acid and serum cystatin C in hypertensive patients increased far earlier than blood urea and serum creatinine did. Conclusion The blood uric acid and serum cystatin C are the sensitive indicators of hypertension with early renal damage.The sensitivity of blood uric acid and serum cystatin C is higher than the blood ureaand serum creatinine. Therefore,detection of blood uric acid and serum cystatin C level has important clinical value in the diagnosis of hypertension with early renal damage.