高血压病患者早期肾损伤检测指标的变化及其关系探讨

Exploring the Changes of Early Kidney Injury Detection Indicators and Their Relationship in Patients with Hypertension

目的 探讨高血压病患者早期肾损伤检测指标的变化及其关系。方法 回顾性选取于2020年1月—2021年12月仪征市人民医院收治的165例高血压病患者的临床资料作为研究对象,将其纳入观察组;根据血压水平将其分为高血压1级组、高血压2级组、高血压3级组,根据eGFR水平将其分为肾功能正常组、肾功能轻度下降组、肾功能中度及重度下降组,另选取于本院体检正常者95名作为对照组。分别比较不同血压、eGFR水平高血压患者血清Cys C、Hcy、β_(2)-MG、Ccr、UA、Cre、BUN水平,比较各生化指标的相关性。结果 与对照组相比,高血压1~3级组患者血清Cys C、Hcy、β_(2)-MG、UA、Cre、BUN水平均更高,Ccr水平均更低,差异有统计学意义(P<0.05)。与对照组相比,肾功能正常组、肾功能轻度下降组、肾功能中度及重度下降组血清Cys C、Hcy、β_(2)-MG、UA、Cre、BUN水平均更高,Ccr水平均更低,差异有统计学意义(P<0.05)。血清Cys C与血清Hcy、β_(2)-MG、UA、Cre、BUN呈正相关(r=0.101、0.464、0.612、0.387、0.155,P<0.05);血清Hcy与血清β_(2)-MG、UA、Cre、BUN呈正相关(r=0.337、0.519、0.450、0.301,P<0.05);血清UA与血清Cre、BUN呈正相关(r=0.294、0.031,P<0.05);血清Cre与血清BUN呈正相关(r=0.567,P<0.05);Ccr与血清UA、Cre、BUN呈负相关(P<0.05)。结论 血清Cys C、Hcy、β_(2)-MG、UA、Cre、BUN水平随高血压病早期肾损伤患者血压分级、eGFR水平升高而升高,Ccr水平随血压分级、eGFR水平升高而降低,在临床中对以上指标进行检测,有利于早期发现高血压病患者肾功能损伤程度,以改善患者预后。

Objective To explore the changes of early kidney injury detection indexes and their relationship in patients with hypertension.Methods The clinical data of 165 patients with hypertension admitted to the Yizheng People´s Hospital hospital from January 2020 to December 2021 were retrospectively selected as the study subjects,and they were included in the observation group.They were divided into hypertension grade 1 group,hypertension grade 2 group,and hypertension grade 3 group according to their blood pressure levels.They were divided into normal renal function group,mildly declining renal function group,and moderately and severely declining renal function group according to eGFR level.Another 95 patients with normal physical examination in our hospital were selected as the control group.The serum Cys C,Hcy,β2-MG,Ccr,UA,Cre,BUN levels of hypertensive patients with different blood pressure and eGFR levels were compared,and the correlation of each biochemical index was compared.Results Compared with the control group,the levels of serum Cys C,Hcy,β2-MG,UA,Cre and BUN of hypertension of grade 1 to 3 patients were all higher,and the levels of Ccr of hypertension of grade 1 to 3 patients were lower,the difference was statistically significant(P<0.05).Compared with the control group,the levels of serum Cys C,Hcyβ2-MG,UA,Cre and BUN of normal renal function group,mildly declining renal function group,moderately and severely declining renal function group were higher,the level of Ccr were lower and the difference was statistically significant(P<0.05).Serum Cys C was positively correlated with serum Hcy,β2-MG,UA,Cre,and BUN(r=0.101,0.464,0.612,0.387,0.155,P<0.05);serum Hcy was positively correlated with serumβ2-MG,UA,Cre,and BUN(r=0.337,0.519,0.450,0.301,P<0.05);serum UA was positively correlated with serum Cre and BUN(r=0.294,0.031,P<0.05);serum Cre was positively correlated with serum BUN(r=0.567,P<0.05);Ccr was negatively correlated with serumβ2-MG,UA,Cre,and BUN(P<0.05).Conclusion Serum Cys C,UA,Cre,and BUN levels increased with the increase of blood pressure grading and eGFR level in patients with early kidney injury in hypertensive disease,and Ccr levels decreased with the increase of blood pressure grading and eGFR level.The detection of the above indexes in clinical practice is beneficial to the early detection of the degree of renal impairment in patients with hypertension to improve their prognosis.