探究β_(2)微球蛋白、胱抑素C、单核细胞趋化蛋白-1在 高尿酸血症患者肾功能损害早期诊断中的意义

Exploration on significance of β_(2)-MG,Cys C and MCP-1 in early diagnosis of renal function impairment in patients with hyperuricemia

目的探究β_(2)微球蛋白(β_(2)-MG)、胱抑素C(Cys C)、单核细胞趋化蛋白-1(MCP-1)在高尿酸血症(HUA)患者肾功能损害早期诊断中的意义。方法选取2018年6月~2020年3月收治的HUA患者86例作为研究组,另选取同期健康体检者54人作为对照组,抽取两组研究对象空腹静脉血,检测并比较两组血清中β_(2)-MG、Cys C、MCP-1水平,比较研究组中不同性别及是否合并肾功能损害患者血清中上述指标水平,分析血尿酸与血清β_(2)-MG、Cys C、MCP-1水平的相关性,以及β_(2)-MG、Cys C、MCP-1水平对HUA患者肾功能损害的早期诊断价值。结果研究组患者血清β_(2)-MG、Cys C、MCP-1水平显著高于健康对照者(P<0.05);研究组中男性患者血清β_(2)-MG、Cys C、MCP-1水平高于女性患者(P<0.05),合并肾损害患者血清β_(2)-MG、Cys C、MCP-1水平高于未合并肾损伤患者(P<0.05);Pearson相关性分析显示,HUA患者血尿酸水平与血清β_(2)-MG、Cys C、MCP-1均呈正相关(r=0.482、0.463、0.672,P<0.001);β_(2)-MG、Cys C、MCP-1诊断HUA患者肾功能损害的最佳截断值分别为2.05 mg/L、0.95 mg/L、173.87 pg/mL,对应的AUC值分别为0.911(95%CI 0.851~0.952)、0.855(95%CI 0.786~0.909)、0.921(95%CI 0.863~0.960),三项指标联合诊断肾功能损害的灵敏度为87.21%,特异度为98.84%。结论高尿酸血症患者血清β_(2)-MG、Cys C、MCP-1水平上升,可成为高尿酸血症患者肾功能损害早期诊断的有效指标。

Objective To investigate the significance ofβ_(2) microglobulin(β_(2)-MG),cystatin C(Cys C)and monocyte chemoattractant protein-1(MCP-1)in the early diagnosis of renal function impairment of patients with hyperuricemia(HUA).Methods 86 HUA patients admitted to hospital from June 2018 to March 2020 were selected as study group,and 54 healthy people who underwent physical examination during the same period were selected as control group.Fasting venous blood were collected from two groups,the levels ofβ_(2)-MG,Cys C and MCP-1 of the two groups were detected and compared.In addition,the levels of the above-mentioned indicators in serum of patients with different sex and renal impairment in the study group,and correlation between serum uric acid and levels of serumβ_(2)-MG,Cys C and MCP-1 as well as diagnostic value ofβ_(2)-MG,Cys C and MCP-1 levels on renal function impairment in HUA patients were analyzed.Results The levels of serumβ_(2)-MG,Cys C and MCP-1 in the study group were significantly higher than those in the healthy control group(P<0.05).The levels of serumβ_(2)-MG,Cys C and MCP-1 of male patients in the study group were higher than those in female patients(P<0.05).The levels of serumβ_(2)-MG,Cys C and MCP-1 of patients with renal injury were higher than those of patients without renal injury(P<0.05).Pearson correlation analysis showed that the serum uric acid level of HUA patients was significantly positively correlated with serumβ_(2)-MG,Cys C and MCP-1(r=0.482,0.463,0.672,P<0.001).The best cutoff values ofβ_(2)-MG,Cys C,and MCP-1 in the diagnosis of renal function impairment in HUA patients were 2.05 mg/L,0.95 mg/L and 173.87 pg/mL,respectively,and the corresponding AUC values were 0.911(95%CI 0.851-0.952),0.855(95%CI 0.786-0.909)and 0.921(95%CI 0.863-0.960).In addition,the sensitivity and specificity of the combined diagnosis of the above three indexes for renal function impairment were 87.21%and 98.84%,respectively.Conclusion The increases ofβ_(2)-MG,Cys C,and MCP-1 among patients with hyperuricemia may be used as effective indicators for early diagnosis of renal function impairment in patients with hyperuricemia.