老年高血压患者胱抑素C和视黄醇结合蛋白及β2微球蛋白的表达和作用

The expressions and the effects of cystatin C, retinol-binding protein and β2-microglobulin on predicting renal damage in elderly patients with hypertension

目的探讨血清胱抑素C（CysC）、视黄醇结合蛋白（RBP）、血和尿β2微球蛋白（β2-MG）在老年高血压患者的表达水平及其对老年高血压中的作用及意义。方法149例高血压患者按照血压水平分为3级，1级组50例、2级组50例、3级组49例；同期体检的健康老年人92例为对照组。检测高血压不同级别组和对照组CysC、RBP、血和尿β2—MG、血尿素、肌酐和生化指标。观察老年高血压的并发疾病，分析各组间肾功能各项指标的差异及其相关性。结果149例高血压患者高脂血症86例（57．7％）、动脉粥样硬化71例（47．7％）、2型糖尿病59例（39．6％）、冠心病56例（37．6％）、脑血管病49例（32．9％）。CysC、RBP、血和尿β2-MG含量在高血压各级别组中均升高，组间比较差异有统计学意义，且其增高程度与高血压的逐级别增高呈正相关（均P〈0．01）。CysC在高血压1级组、2级组、3级组分别为（1．2±0．5）mg／L、（1.7±0．6）mg／L、（2．2±0．9）mg／L；RBP为（53．1±10．2）mg／L、（65．2±16．3）mg／L、（75．8±17．5）mg／L；血β2-MG为（2．7±1．5）mg／L、（4．0±2．1）mg／L、（4．9±2．0）mg／L；尿β2MG为（178．3±73．9）ng／L、（237．9±78．6）ng／L、（277．5±87．5）ng／L，与对照组比较差异有统计学意义（P〈0．05或P〈0．01）。结论老年高血压可合并多种疾病。CysC、RBP、血和尿β2-MG的检测对高血压。肾损害有诊断价值，是反映高血压早期肾损害的敏感指标。

Objective To investigate the expressions of serum cystatin C （CysC）, retinol- binding protein （RBP）, serum and urinary β2-microglobulin （13z-MG） and their effects on predicting renal damage in primary hypertension in elderly patients. Methods A total of 149 patients were divided into 3 groups of hypertension grade 1 （n = 50）, hypertension grade 2 （n=50） and hypertension grade 3 group （n=49）. 92 healthy controls who took physical examination were selected as control group. The levels of serum CysC, RBP, serum and uric 132-MG, blood urea nitrogen, creatinine and other biochemical indexes were detected. The complications of hypertension were observed. The differences in renal function indexes between groups and their correlations were analyzed. Results There were 86 cases with hyperlipidemia （57.7%）, 71 cases with atherosclerosis （47.7%）, 59 cases with type 2 diabetes mellitus （39.6%）, 56 cases with coronary heart disease （37.6%）, and 49 cases with cerebral vascular disease （32.9%） in 149 hypertensive patients. The levels of serum CysC, RBP, serum and uric β2-microglobulin were increased in hypertensive patients as compared with healthy controls （P〈0.05 or 0.01）, and the extents of increments in the above indexes were positively correlated with blood pressure level CysC.. （1.2 ± 0.5） mg/L, （1.7±0.6） mg/L, （2.2±0.9） mg/L.RBP： （53.1±10.2） mg/L, （65.2±16.3）rag/L, （75.8±17.5） mg/L;seruml3z-MG： （2.7±1.5） mg/L, （4.0±2. 1） mg/L, （4.9±2.0） mg/L;uric132-MG： （178.3±73.9） ng/L, （237.9±78.6） ng/L, （277.5±87.5） ng/L; respectively, P〈0.05 or 0. 011. Conclusions Elderly hypertensive patients are complicated with a variety of diseases. The levels of serum CysC, retinol-binding protein, serum and uric β2-microglobulin have significant diagnostic values on renal impairment caused by hypertension, and can be considered as sensitive factors for early renal impairment in essential hypertension.