胱抑素C和尿酸对哈萨克族H型高血压患者初期肾损害的诊断价值研究

Diagnostic Value of Cystatin C and Uric Acid for Early Renal Impairment in Kazakh Patients with H-type Hypertension

背景胱抑素C(CysC)、尿酸(UA)与高血压患者的肾损害密切相关,已成为近年来研究的热点。目的探讨CysC、UA对哈萨克族H型高血压患者初期肾损害的诊断价值。方法随机抽取2014年5月—2015年8月参与新疆地区流行病学调查的哈萨克族H型高血压患者318例为研究对象,依据估算肾小球滤过率(eGFR)将患者分为肾损害组[n=174,eGFR<90 ml·min^(-1)·(1.73 m^2)^(-1)]、肾功能正常组[n=144,eGFR≥90 ml·min^(-1)·(1.73m^2)^(-1)]。比较两组患者的基线资料;分析CysC、UA与eGFR的相关性,哈萨克族H型高血压患者初期肾损害的影响因素以及CysC、UA诊断哈萨克族H型高血压患者初期肾损害的价值。结果肾损害组患者年龄、收缩压(SBP)、舒张压(DBP)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、血尿素氮(BUN)、肌酐(Cr)、同型半胱氨酸(Hcy)、CysC、UA高于肾功能正常组(P<0.05)。CysC、UA与e GFR呈负相关(r值分别为-0.791、-0.671,P<0.05)。多因素Logistic回归分析结果显示,LDL-C、CysC、UA是哈萨克族H型高血压患者初期肾损害的影响因素(P<0.05)。CysC、UA诊断哈萨克族H型高血压患者初期肾损害的受试者工作特征曲线(ROC)曲线下面积(AUC)分别为0.967[95%CI(0.946,0.989)]、0.875[95%CI(0.837,0.913)]。结论哈萨克H型高血压患者CysC、UA与初期肾损害有相关性,并对其有一定的诊断价值,可作为诊断初期肾损害的重要指标。

Background Cystatin C(CysC)and uric acid(UA)are closely related to renal impairment in patients with hypertension,and have become a hot research topic in recent years.Objective To investigate the value of CysC and UA in diagnosis of early renal impairment in Kazakh patients with H-type hypertension.Methods A total of 318 Kazakh patients with H-type hypertension who participated in the epidemiological investigation in Xinjiang between May 2014 and August 2015 were selected randomly.According to their eGFR levels,the patients were divided into a renal function impairment group〔n=174,eGFR<90 ml·min^-1·(1.73 m^2)^-1〕and a normal renal function group〔n=144,eGFR≥90 ml·min^-1·(1.73 m^2)^-1〕.Baseline data were compared between the two groups,and the correlations among CysC,UA and eGFR were analyzed.Factors influencing early renal impairment in Kazakh patients with H-type hypertension,as well as the value of CysC and UA in diagnosis of the condition,were investigated.Results The indicators age,systolic blood pressure(SBP),diastolic blood pressure(DBP),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),blood urea nitrogen(BUN),creatinine(Cr),homocysteine(Hcy),CysC and UA were higher in the renal function impairment group than in the normal renal function group(P<0.05).CysC and UA were negatively correlated with eGFR(r=-0.791 and-0.671,P<0.05).Multivariate Logistic regression showed that LDL-C,CysC,and UA were influencing factors for early renal impairment in Kazakh patients with H-type hypertension(P<0.05).The areas under the ROC curve(AUC)of CysC and UA in the diagnosis of early renal impairment in these patients were 0.967〔95%CI(0.946,0.989)〕and 0.875〔95%CI(0.837,0.913)〕.Conclusion CysC and UA are correlated with early renal impairment in Kazakh patients with H-type hypertension and are a favorable indicator for the diagnosis of early renal impairment.