生化和尿液指标联合检测对早期高血压肾病诊断的意义

Significance of biochemical and urinary indicators in diagnosis of early hypertensive nephropathy

目的:分析生化指标血清胱抑素C(Cys-C)、脂蛋白a[Lp(a)],尿液指标尿微量白蛋白(U-mAlb)联合检测对早期高血压肾病诊断的意义。方法:选取2016年2月至2021年2月收治的50例高血压肾病(观察组)和63例高血压肾功能正常(对照组)患者作为研究对象,并选取同期进行体检的60例健康者作为健康组,检测血清Cys-C、LP(a)、U-mAlb水平,并采用受试者工作(ROC)曲线分析血清Cys-C、LP(a)、U-mAlb对高血压肾病的诊断价值。结果:观察组血清Cys-C、LP(a)、U-mAlb水平高于对照组和健康组,对照组血清Cys-C、LP(a)、U-mAlb水平高于健康组(P<0.05)。观察组Cys-C、LP(a)、U-mAlb阳性率高于对照组和健康组,对照组Cys-C、LP(a)、U-mAlb阳性率高于健康组(P<0.05)。ROC曲线分析显示,血清Cys-C、LP(a)、U-mAlb水平联合诊断早期高血压肾病的敏感度为96.00%,受试者工作曲线面积为0.898,均高于单独检测(P<0.05)。Spearman相关分析显示,血清Cys-C、LP(a)水平与U-mAlb呈正相关性(P<0.05)。结论:血清Cys-C、LP(a)、U-mAlb联合检测可作为高血压肾病的早期诊断指标,对于高血压肾病的预防具有重要意义。

Objective: To analyze the significance of joint detection of serum cystatin C(Cys-C), lipoprotein(a)(Lp[a]) and urine microalbumin(U-mAlb) in the diagnosis of early hypertensive nephropathy. Methods: A total of 50 patients with hypertensive nephropathy(observation group) and 63 hypertensive patients with normal renal function(control group) were selected as the research subjects between February 2016 and February 2021. Meanwhile, 60 healthy persons were selected as the healthy group. Serum Cys-C, Lp(a) and U-mAlb levels were detected. The ROC curve was used to analyze the diagnostic value of serum Cys-C, Lp(a) and U-mAlb for hypertensive nephropathy. Results: Serum Cys-C, Lp(a) and U-mAlb levels in the observation group, the control group, and the healthy group decreased in order(P<0.05). The positive rates of Cys-C, Lp(a) and U-mAlb in the observation group, the control group, and the healthy group also decreased in order(P<0.05). ROC curve analysis showed that the sensitivity and AUC value of joint diagnosis of early hypertensive nephropathy with serum Cys-C, Lp(a) and U-mAlb levels were 96.00% and 0.898, which were higher than those of single index detection(P<0.05). Spearman correlation analysis showed that serum Cys-C and Lp(a) levels were positively correlated with U-mAlb(P<0.05). Conclusion: The joint detection of serum Cys-C, Lp(a) and U-mAlb could be used for early diagnosis of hypertensive nephropathy, which might be of great significance for the prevention of hypertensive nephropathy.