老年慢性阻塞性肺疾病患者早期肾损伤指标的检测及意义

The detection and significance of early indicators of kidney damage in patients with chronic obstructive pulmonary disease

目的探讨血清胱抑素C、β2微球蛋白、α1微球蛋白、血清肌酐检测对老年慢性阻塞性肺疾病(COPD)患者早期肾损伤的临床诊断价值及意义。方法选择2013年10月-2015年1月来本院就诊的132例老年COPD患者为研究对象,依据氧分压分为3个亚组,另选取60例健康者为对照组,检测4组Cys-C、β2-MG、α1-MG、Scr水平并进行比较分析。结果与对照组比较,COPD组Cys-C、β2-MG、α1-MG水平均明显升高,COPD组Scr水平与对照组差异无统计学意义(P>0.05);Cys-C水平在A组、B组、C组均显著高于对照组,差异有统计学意义(P<0.05);β2-MG、α1-MG水平在B组、C组均显著高于对照组,差异有统计学意义(P<0.05);与A组比较,C组Cys-C、β2-MG、α1-MG水平较高,差异有统计学意义(P<0.05);与B组比较,C组Cys-C水平较高,差异有统计学意义(P<0.05);β2-MG、α1-MG与Cys-C均呈正相关(r值分别为0.436、0.579,P<0.05)。结论血清Cys-C、β2-MG、α1-MG可评估早期肾损伤,可作为老年COPD患者早期肾损伤的监测指标。

Objective To discuss the detection and significance of early indicators of kidney damage for serum Cys- C,β2-MG,α1- MG,Scr,e GFR in patients with chronic obstructive pulmonary disease（ COPD）. Methods A total of 132 elderly patients with COPD from October 2013 to January 2015 in our hospital were selected as the study object. The patients were divided into three subgroups based on partial pressure of oxygen（ SPO2）. A total of 60 healthy people were selected as control group. The Cys- C,β2- MG,α1- MG,Scr levels were detected and compared for analysis. Results Compared with control group,Cys- C,β2- MG,α1- MG levels in COPD group significantly increased,and the Scr levels had no statistical significance on the difference with the control group（ P〈 0. 05）. Cys- C level in A,B,C group were significantly higher than that in control group,and the differences had no statistical significance（ P〈 0. 05）; β2- MG,α1- MG levels in B,C group were significantly higher than that in control group,and the differences were statistically significant（ P〈 0. 05）. Compared with group A,Cys- C,β2- MG,α1- MG levels in group C were higher,and the difference had statistical significance（ P〈 0. 05）; compared with group B,Cys- C level in group C were higher,and the differences were statistically significant（ P〈 0. 05）; β2-MG,α1- MG and Cys- C were negatively correlated（ r = 0. 436 0. 579,P〈 0. 05）. Conclusion The results show that Cys- C,β2- MG,α1- MG can evaluate early kidney damage in patients with COPD; it can be used as early indicators for monitoring elderly kidney damage in COPD patients.