血清胱抑素C对原发性高血压早期肾功能损害的诊断价值

Clinical application of serum cystatin C in early renal function injury patients caused by hypertension

目的探讨血清胱抑素C(Cys C)在原发性高血压早期肾功能损害诊断中的作用。方法选取原发性高血压患者186例作为观察对象,按高血压程度分为高血压Ⅰ级组、高血压Ⅱ级组、高血压Ⅲ级组,每组62例。检测患者肾小球滤过率(GFR)和Cys C,分析GFR、Cys C浓度与原发性高血压程度的关系。结果不同血压水平的三组患者的GFR值差异有统计学意义(P<0.05),Ⅰ级组>Ⅱ级组>Ⅲ级组;三组患者的血清Cys C浓度差异有统计学意义(P<0.05),Ⅲ级组>Ⅱ级组>Ⅰ级组;三组患者的血清肌酐、尿素氮、尿酸差异无统计学意义(P>0.05)。相关分析结果显示,患者血压水平与GFR值呈负相关(r=-0.491),与Cys C浓度呈正相关(r=0.835)。结论 Cys C的浓度测定方法简便、迅速、灵敏,可作为临床诊断、预测原发性高血压早期肾功能损害的指标,值得临床推广应用。

Objective To analyze the clinical effect of serum cystatin C （Cys C） in early renal function injury patients caused by hypertension. Methods 186 patients with essential hypertension were divided into hypertension grade I group, hypertension grade Ⅱ group, hypertension grade m group according to the degree of high blood pressure,62 cases in each group. The level of GFR and Cys C were detected, and the correlation analysis between GFR, Cys C and the degree of essential hypertension was carried out. Results The value of GFR in hypertension grade I group was higher than that in hypertension grade Ⅱ group, and the hypertension grade Ⅲ group was the least, the difference between the three groups was statistically significant（P 〈 0.05） ; the level of serum Cys-C had statistical significance in three groups （P 〈 0. 05 ）, and the level of serum Cys-C increase with the renal function impairmen; there was no significant difference in detecting rate of the serum creatinine, urea nitrogen, uric acid in three groups （P 〉0.05） . The correlation analysis results show that the level of blood pressure was negatively correlated to GFR（ r = -0. 491 ） but positive correlated with serum Cys-C （ r = 0.835）. Conclusions The detection of serum Cys C is simple, rapid and sensitive, it can be an index for diagnosis and predicting of renal dysfunction in patients with hypertension, which is worth to populate and apply.