高血压患者红细胞分布宽度及血清胱抑素C水平与尿蛋白肌酐比值的关系

Relationship between red blood cell distribution width, serum cystatin C level and UACR in patients with hypertension

目的 观察高血压患者尿微量白蛋白肌酐比值、血清胱抑素C水平及血红细胞分布宽度（RDW）的关系,探讨红细胞分布宽度、胱抑素C水平与高血压早期肾损害的关系.方法 入选高血压患者266例,根据尿微量白蛋白/肌酐比值（UACR）分为高血压肾脏正常组152例（UACR＜30 mg/g）和高血压早期肾损害组114例（UACR≥30 mg/g）,检测患者血脂、空腹血糖、血清胱抑素C、血常规、肌酐（Scr）、尿素氮（BUN）、尿微量白蛋白、尿肌酐,测量体质指数（BMI）,调查有无吸烟、饮酒等危险因素.另设对照组50例（选自我院体检中心健康体检者）.结果 ①与对照组相比,高血压肾脏正常组及高血压早期肾损害组RDW水平均明显升高[（13.43±0.92）％比（15.05±1.29）％比（12.09±0.57）％],差异有统计学意义（P均＜0.01）;高血压早期肾损害组血清胱抑素C水平明显升高[（1.46±0.22）mg/L比（1.16±0.18）mg/L,P＜0.01].②与高血压肾脏正常组比较,高血压早期肾损害组RDW水平[（15.05±1.29）％比（13.43±0.92）％]及胱抑素C水平[（1.46±0.22）mg/L比（1.20±0.19）mg/L]均明显升高,差异均有统计学意义（P均＜0.01）.③高血压组随着血压水平的升高、UACR的增加,RDW水平逐渐增加.④高血压组RDW与UACR、血清胱抑素C水平、平均收缩压呈正相关（r值分别为0.596、0.633和0.479,P均＜0.01）.结论 RDW指标简单易获得,可作为原发性高血压早期肾损害的预测指标,联合血清胱抑素C水平预测价值更高.

Objective To observe the correlation of urinary albumin-to- creatinine ratio （UACR）, serum cystatin C level and red blood cell distribution width in patients with primary hypertension. Methods 266 primary hypertensive patients were divided into two groups according to UACR. A group： 152 primary hypertensive patients with normal renal function （UACR〈30 mg/g）. B group： 114 primary hypertensive patients with early-stage renal function damage（UACR 〉/30 mg/g）. While 50 healthy controls without hypertension were enrolled as Control group （C group）. TC, TG, LDL-C, HDL-C, fasting blood glucose, cystatin C, RDW, Cr, BUN, urine albumin, urine creatinine, body mass index （BMI）, smoking and drinking were analyzed respectively. Results （1）There were significant differences in RDW among the three groups. Compared with C group, RDW was significantly in- creased in hypertension group[（13.43±0.92）% vs（ 15.05±1.29）% vs （12.09±0.57）%, all P〈0.01 ]. With UACR level increased, RDW was increased gradually（P〈0.01 ）. （2）The serum cystatin C level of B group was significantly higher than C group[（1.46±0.22）mg/L vs （1.16±0.18）mg/L] and A group[（1.46±0.22）mg/L vs （1.20±0.19）mg/L] （all P〈0.01 ）. （3）Correlation analysis showed that, RDW was positively correlated with UACR, the serum level of cystatin C and mean SBP （r=0.596, 0.633, 0.479, all P〈0.01 ）. Conclusion RDW, as an ease measurable in- dex, can predict early-stage renal function damage in primary hypertensive patients. When used combined with cystatin C, predictive value can be more.