肾脏功能指标检测及其在高血压肾病中的临床表达

Clinical expression of renal function indicators detection in hypertensive nephropathy

目的探讨血清胱抑素C(Cys C)与传统肾功能检测指标在高血压肾病监测中的临床表达。方法 150例高血压肾病患者,其中Ⅰ、Ⅱ、Ⅲ期各50例,采用全自动化学法分别测定各期患者血清Cys C、尿素(UR)、肌酐(SCR)含量,并进行比较,分析各指标在各期患者中的表达,评价各指标在高血压肾病中的监测效能。结果Ⅰ期高血压肾病患者Cys C为(1.39±0.22)mg/L、UR为(9.86±1.52)mmol/L、SCR为(139.0±22.5)μmol/L,Ⅱ期高血压肾病患者Cys C为(2.13±0.35)mg/L、UR为(10.07±1.71)mmol/L、SCR为(145.0±23.1)μmol/L,Ⅲ期高血压肾病患者Cys C为(2.94±0.51)mg/L、UR为(10.71±2.06)mmol/L、SCR为(153.0±24.7)μmol/L。高血压肾病Ⅲ期患者Cys C含量高于Ⅰ、Ⅱ期患者(P<0.05),Ⅱ期患者Cys C含量高于Ⅰ期患者(P<0.05);高血压肾病Ⅰ期与Ⅱ期患者、Ⅱ期与Ⅲ期患者UR、SCR含量比较差异均无统计学意义(P>0.05),Ⅰ期患者UR、SCR含量低于Ⅲ期患者(P<0.05)。结论高血压肾病患者存在不同程度的肾功能改变,血清Cys C测定较传统UR、SCR监测更能反映患者早期肾损伤。

Objective To investigate clinical expression of serum cystatin C（Cys C） and renal function indicators in monitoring of hypertensive nephropathy. Methods A total of 150 hypertensive nephropathy patients, with 50 cases in each stages of Ⅰ, Ⅱ and Ⅲ, all received automatic chemical test to detect serum Cys C, urea（UR）, and creatinine（SCR） contents for comparison. Expressions of indicators were analyzed, and their function in monitoring of hypertensive nephropathy was evaluated. Results Stage Ⅰ hypertensive nephropathy patients had Cys C as（1.39±0.22）mg/L, UR as（9.86±1.52）mmol/L and SCR as（139.0±22.5）μmol/L. Stage Ⅱ hypertensive nephropathy patients had Cys C as（2.13±0.35）mg/L, UR as（10.07±1.71）mmol/L and SCR as（145.0±23.1）μmol/L. Stage Ⅲ hypertensive nephropathy patients had Cys C as（2.94±0.51）mg/L, UR as（10.71±2.06）mmol/L and SCR as（153.0±24.7）μmol/L. Stage Ⅲ hypertensive nephropathy patients had higher Cys C content than stages Ⅰ and Ⅱ patients（P〈0.05）, and stage Ⅱ patients had higher Cys C than stage Ⅰ cases（P〈0.05）. There was no statistically significant difference of UR and SCR contents between stages Ⅰ and Ⅱ, and stages Ⅱ and Ⅲ patients（P〈0.05）, while stage Ⅰ cases had lower UR and SCR than stage Ⅲ cases（P〈0.05）. Conclusion Various renal function changes are shown in hypertensive nephropathy patients, and serum Cys C can show better reflection of early renal injury in monitoring than UR and SCR.