原发性高血压早期肾损害患者胱抑素C联合同型半胱氨酸检测的临床意义

Clinical significance of detection of serum cystatin C combining homocysteine in patients with early renal damage induced by primary hypertension

目的探讨原发性高血压早期肾损害患者检测血清胱抑素C(CysC)、同型半胱氨酸(Hcy)的临床意义。方法选择巨野县人民医院于2015年2月~2016年8月收治的原发性高血压患者120例,男性71例,女性49例。将肾小球滤过率(GFR)≥80 ml/(min·1.73 m2)患者纳入高血压组(62例);将GFR<80 ml/(min·1.73 m^2)患者纳入早期肾损害组(58例);同期纳入健康体检者作为健康组(60例),既往无急慢性疾病史。检测患者入院时和健康组体检时血清CysC及Hcy水平。测定入院时的肾小球滤过率。CysC(>1.1 mg/L)、Hcy(>15μmol/L)诊断为早期肾损害。结果健康组、高血压组、早期肾损害组血清CysC、Hcy水平均呈升高趋势,差异有统计学意义(P均<0.05)。单项CysC、Hcy检测的阳性率低于CysC联合Hcy检测,69.0%vs.94.8%,63.8%vs.94.8%,差异有统计学意义(P均<0.05)。原发性高血压早期肾损害患者GFR与血清CysC、Hcy水平均呈负相关,相关系数分别为-0.576、-0.341(P均<0.05)。结论血清胱抑素C及同型半胱氨酸联合检测有利于原发性高血压早期肾损害的诊断,指导临床治疗。

Objective To investigate the clinical significance of detection of serum cystatin C(Cys C)combining homocysteine(Hcy)in patients with early renal damage induced by primary hypertension.MethodsThe patients with primary hypertension(n=120,male71and female49)were chosen from the People’s Hospitalof Juye County from Feb.2015to Aug.2016.The patients with glomerular filtration rate(GFR)≥80ml/(min·1.73m2)were chosen into hypertension group(n=62),those with GFR<80ml/(min·1.73m2),into early renal damagegroup(n=58),and the same term health controls,into health group(n=60).The levels of Cys C and Hcy weredetected when patients hospitalized and health controls with physical examinations.GFR was detected in all groupsat hospitalization time.The early renal damage could be diagnosed when Cys C>1.1mg/L and Hcy>15μmol/L.Results The levels of Cys C and Hcy showed an ascending trend in all3groups(all P<0.05).The positive rateof single Cys C detection or single Hcy detection was lower than that of detection of Cys C combining Hcy(69.0%vs.94.8%;63.8%vs.94.8%,all P<0.05).GFR was negatively correlated to the levels of serum Cys C and Hcy(r=-0.576;r=-0.341,all P<0.05)in patients with early renal damage induced by primary hypertension.ConclusionThe combined detection of Cys C and Hcy is beneficial to the diagnosis of early renal damage induced by primaryhypertension,and can be used for guiding clinical treatment.