血清胱抑素C在高血压患者早期肾损害评价中的应用

Evaluation of the diagnosis value of serum cystatin C for early renal impairment in patients with hypertension

目的:探讨血清胱抑素C在原发性高血压早期肾损害中的诊断价值。方法:选取2014年10月至2015年3月就诊石河子大学医学院第一附属医院老年病科的原发性高血压患者209例,其中18mg/g≤尿白蛋白/肌酐(UACR)≤300mg/g为高血压微量白蛋白尿(MA)组19例,匹配UACR<18mg/g为高血压正常白蛋白尿(NA)组19例;另外同期选取健康体检患者19例为健康对照组。比较各组间血清胱抑素的差异,并分析血清胱抑素C与UACR、e GFR的相关性。采用ROC曲线计算血清胱抑素C诊断原发性高血压患者早期肾损伤的临界点。结果:MA组血清胱抑素C高于NA和对照组(均<0.05),NA组血清胱抑素C与对照组无差异(>0.05)。e GFR与血清胱抑素C呈负相关(=-0.655,<0.05);与UACR不相关。根据受试者工作特征(ROC)曲线,血清胱抑素C诊断原发性高血压患者早期肾损伤的最佳临界点为0.94mg/L,其敏感度为63.2%,特异度为76.3%,ROC曲线下面积为0.726。结论:血清胱抑素C是原发性高血压患者早期肾功能损伤的重要诊断指标之一。

Objective：To evaluate the diagnostic value of serum cystatin C（Cys C） for early renal impairment in patients with essential hypertension.Methods：209 inpatients with essential hypertension admitted in our department from October 2014 to March 2015 were recruited in this study, including only 19 cases whose urinary albumin to creatinine ratio（UACR） ranged from 18mg/g to 300mg/g as microalbuminuria（MA） group.Normal albuminuria（NA） group were matched according to UACR level below 18mg/g in our population.19 cases of healthy volunteers were chosen as control group.Serum Cys C levels among 3 groups were compared and the correlation between serum cystatin C and e GFR was analyzed.The receiver operating characteristic（ROC） curve was used to confirm the cut-off value,which was serum Cys C level in diagnosis of early renal damage in patients with essential hypertension.Results：The serum Cys C level in MA group was significantly higher than that in NA group and control group（ 0.05）.There was no statistical difference in the level of serum Cys C between NA group and control group（ 0.05）.Serum Cys C was negatively correlated with e GFR（r=-0.655, 0.05）,and was not correlated with UACR.According to the ROC curve,the best cut-off value of diagnosing patients with primary hypertension and early renal impairment was 0.94mg/L.The sensitivity and specificity were 63.2% and 76.3%.The area under the ROC curve was 0.726.Conclusions：Serum Cys C is one of the important diagnostic indicators of patients with essential hypertension and early renal injury.