慢性肾脏病患者血清同型半胱氨酸、肌酐的检测及临床意义

Clinical Significance of Measurements of Serum Homocysteine and Creatinine in Patients with Chronic Kidney Disease

目的探讨慢性肾脏病患者血清同型半胱氨酸(Hcy)、肌酐(Cr)水平的变化及临床意义。方法选择190例慢性肾脏病患者[试验组,肾功能代偿期(A组)57例,氮质血症期(B组)48例,肾功能衰竭期(C组)36例,肾功能不全终末期(D组)49例]及180例健康体检者(正常对照组),分别检测各组血清Hcy、Cr的水平。结果与正常对照组比较,试验组血清Hcy、Cr水平,A组血清Hcy水平,B、C、D 3组血清Hcy、Cr水平均明显升高(均P<0.01)。与A组比较,B、C、D 3组血清Hcy、Cr水平均明显升高(均P<0.01);与B组比较,C、D 2组血清Hcy、Cr水平均明显升高(P<0.05或P<0.01);与C组比较,D组血清Hcy、Cr水平均明显升高(P<0.05或P<0.01)。结论 Hcy在肾功能代偿期即可升高,Hcy能够更早提示肾功能损伤,Hcy、Cr联合检测对慢性肾脏病的诊断具有重要的意义。

Objective To investigate the changes in serum levels of homocysteine（Hcy）and creatinine（Cr）and their clinical significance in patients with chronic kidney disease（CKD）.Methods Serum levels of Hcy and Cr were measured in 180 healthy subjects（control group）and 190 CKD patients（experimental group）,including 57 patients with renal compensation（group A）,48 patients with azotemia（group B）,36 patients with renal failure（group C）,and 49 patients with end-stage renal insufficiency（group D）.Results Compared with control group,significant increase was observed in Hcy levels in group A,as well as in both Hcy and Cr levels in groups B,C and D（P〈0.01）.Compared with group A,levels of Hcy and Cr increased in groups B,C and D（P〈0.01）.Compared with group B,levels of Hcy and Cr increased in groups C and D（P〈0.05 or P〈0.01）.Compared with group C,levels of Hcy and Cr increased in group D（P〈0.05 or P〈0.01）.Conclusion Serum Hcy levels may increase in renal compensatory period,suggesting that Hcy can prompt kidney damage earlier.The combined detection of Hcy and Cr is of great significance to the diagnosis of CKD.