血清胱抑素C、叶酸、维生素B_(12)在慢性肾脏病早期肾损伤中的应用价值

Clinical Value of Serum Cystatin C,Folic Acid and Vitamin B_(12) Levels in Early Diagnosis of Renal Function Injury in Chronic Kidney Disease

目的探讨血清胱抑素C(Cys-C),叶酸(FA)、维生素B12(Vit B12)在慢性肾脏病早期肾损伤中的应用价值。方法选择2014年3月至2016年8月在我院就诊的慢性肾脏病患者167例作为研究对象,按照慢性肾脏病的分期分为五组:第1期组(A组,32例)、第2期组(B组,32例)、第3期组(C组,33例)、第4期组(D组,34例)、第5期组(E组,36例),选择同期体检健康志愿者30例作为健康对照组,采用胶乳免疫比浊法测定血清Cys-C,电化学发光法测定血清FA和Vit B12,尿素酶-谷氨脱氢酶法测定血清尿素(Urea),苦味酸法测定血清肌酐(Scr)含量水平。结果 A组各指标测定结果与对照组比较差异无统计学意义(P>0.05);B组Scr、Urea与对照组及A组比较差异也无统计学意义(P>0.05),而血清Cys-C高于对照组和A组(P<0.05);C组、D组和E组各指标测定结果与对照组及A组比较差异均有统计学意义(P<0.05)。ROC曲线显示,Cys-C、Urea、FA、Vit B12、Scr的AUC及95%CI分别为:0.697(0.668~0.887)、0.538(0.491~0.792)、0.502(0.504~0.822)、0.481(0.532~0.865)、0.457(0.484~0.775)。结论血清胱抑素C、叶酸和维生素B12检测有助于早期肾功能损伤的判断,对控制慢性肾脏病发展有重要的临床意义。

Objective To explore the early diagnosis values of serum cystatin C （Cys-C）, folic acid and vitamin B12 levels in chronic kidney disease. Methods 97 patients with chronic kidney disease from March 2015 to August 2016 in our hospital were divided into 5 groups according to the staging： the first stag group （ A group, n = 20）, the second stag group （ group B, n = 18 ）, the third stag group （ Group C, n = 21 ）, the fourth stag group（group D, n = 19） and the fifth stag group（group E, n = 19）, while 30 cases of healthy volunteers as healthy control group, the level of serum Cys-C were detected by latex immune turbidimetry, the level of serum folic acid and vitamin B12 were detected by electrochemiluminescence, the level of serum Urea were detected by enzymatic urea enzyme -pancreatic dehydrogenation method, the level of serum Scr were detected by picric acid method. Results Kidney function index of group A had no significant difference compared with the control group（P 〉 0.05 ）. Scr, Urea, folic acid and vitamin B12 in group B had no significant difference compared with group A and the control group （ P 〉 0.05 ）. But Cys- C in group B were significant higher than group A and control group （ P 〈 0.05 ）. Each index of group C, group D and group E had significantly difference compared with group A and the control group. ROC curves showed that the AUC and 95%CI of Cys-C ,Urea,FA,Vit B^2 and Scr were 0. 697 （ 0. 668 -0.887） ,0.538（0.491 -0.792）, 0. 502 （ 0. 504 -0.822） ,0.481 （0.532 - 0.865 ） ,0.457 （0.484 - 0.775 ）. Conclusion The combination of detection of Serum Cys- C, folic acid and vitamin B12 is helpful to the early diagnosis of renal injury, it also has clinical value to control the development of chronic kidney disease.