血清胱抑素C检测对早期高血压肾病的临床价值

The importance of serum cystatin C in the early diagnosis of hypertensive nephropathy

目的研究血清胱抑素C(CysC)在高血压肾病早期的诊断价值。方法对305例高血压患者组及330例健康对照组,均进行血清CysC、肌酐(CREA)、尿素氮(BUN)三项指标检测。CysC检测采用兔疫透射比浊法,CREA及BUN检测均采用酶法。结果高血压患者组血清CysC阳性率(55.1%)明显高于其血清CREA(38.7%)及BUN(42.3%)(P<0.01);轻度CysC增高患者组(A组)血清CysC阳性率与CREA、BUN比较皆有统计学意义(P<0.01),中、重度增高组(B、C组)血清CysC阳性率与CREA、BUN比较皆无统计学意义(P>0.05);1级高血压患者组血清CysC水平明显高于对照组(P<0.01),而血清CREA、BUN至2、3级才明显高于对照组。结论高血压肾病患者血清CysC的增高明显早于血清CREA和BUN,采用CysC对早期高血压肾病诊断比CREA、BUN敏感性更高、特异性更强,对高血压肾病的早期诊断有重要临床价值。

Objective To study the importance of serum cystatin （Cys）C in the early diagnosis of hypertensive ne-phropathy.Methods To test serum CysC-detected by immune transmission turbidity method,serum creatinine （CREA）and blood urea nitrogen （BUN）-determined by enzyme method,in patients with hypertension and healthy volunteers （n=305 and 330,respectively）.Results The positive rate of serum CysC （55.1%）was significantly higher than that of serum CREA （8.7%）or BUN （42.3%）（P 〈0.01）in patients with hypertension.Patients with serum CysC slightly increased （group A）had higher serum CysC positive rate than that of serum CREA and BUN （P 〈0.01）.There was no statistical significance （P 〉0.05）between serum CysC and CREA or BUN in patients with serum CysC moderately and severely increased （group B and C,respectively）.Patients have grade 1 hypertendion had higher level of serum CysC than normal control （P 〈0.01）,while only patients with grade 2 and 3 hypertension could be test-ed having higher CREA and BUN.Conclusion Serum CysC increases much earlier than CREA and BUN in patients with hypertension.It is more sensitive and special and has more marked clinic value using CysC to diagnose early-phase hypertensive.