U-mALB联合全血hs-CRP、血清CysC、血清Hcy检测在高血压肾病早期诊断中的应用

Application of detection of U-mAlb combined with whole blood hs-CRP,serum CysC and Scrum Hcy in early diagnosis of hypertensive nephropathy

目的探究尿微量清蛋白(U-mALB)联合全血超敏C反应蛋白(hs-CRP)、血清胱抑素C(CysC)、血清同型半胱氨酸(Hcy)检测在高血压肾病早期诊断中的应用价值。方法选取2017年5月至2019年4月在该院诊治的高血压患者63例作为观察组,按照有无肾病分为观察A组(n=21,单纯高血压)和观察B组(n=42,高血压肾病);另选取同期在该院进行体检的45例健康者作为对照组,检测所有研究对象U-mALB、全血hs-CRP、血清CysC、血清Hcy水平;ROC曲线分析U-mALB、全血hs-CRP、血清CysC、血清Hcy对高血压肾病的诊断价值。结果 U-mALB、全血hs-CRP、血清CysC、血清Hcy检测水平对照组<观察A组<观察B组,差异均有统计学意义(P<0.05);观察B组4项指标联合检测阳性率明显高于U-mALB、全血hs-CRP、血清CysC、血清Hcy单项检测,差异均有统计学意义(P<0.05)。ROC曲线分析显示,4项指标联合检测对高血压肾病的诊断价值最高(ROC曲线下面积=0.994,灵敏度为100.0%,P<0.05)。结论 U-mALB、全血hs-CRP、血清CysC、血清Hcy均参与了早期高血压肾病的发生和发展,且临床可通过4项指标联合检测及早诊断高血压患者的肾损伤情况。

Objective To explore the value of detection of urinary microalbumin(U-mAlb)combined with whole blood hypersensitive C-reactive protein(hs-CRP),Cystatin C(CysC)and homocysteine(Hcy)in the early diagnosis of hypertension nephropathy.Methods From May 2017 to April 2019,a total of 63 patients with high blood pressure treated by our hospital were selected as observation group.According to the presence or absence of kidney disease,they were divided into observation group A(n=21,simple hypertension)and observation group B(n=42,hypertensive nephropathy).And a total of 45 healthy people who underwent physical examination in our hospital at the same time were selected as the control group.The serum CysC,Hcy levels,U-mAlb and whole blood hs-CRP were measured,and the diagnostic value of U-mAlb combined with whole blood hs-CRP,serum CysC and Hcy in hypertensive nephropathy were analyzed by ROC curve.Results The levels of U-mAlb and whole blood hs-CRP,CysC,Hcy in each group showed the trend of control group<observation group A<observation group B(P<0.05).The positive rate of combined detection of four indicators in group B were significantly higher than that of U-mAlb,whole blood hs-CRP,CysC and Hcy detected alone(P<0.05).The ROC curve showed that the combined detection of four indicators had the highest diagnostic value for hypertensive nephropathy(Area Vnder Curve=0.994,sensitivity was 100.0%,P<0.05).Conclusion U-mAlb,whole blood hs-CRP,serum CysC,Hcy are involved in the occurrence and development of early hypertensive nephropathy,and combined detection of four indicators can be used to diagnose renal injury in patients with hypertension.