血α1、β2微球蛋白和胱抑素C及尿微量蛋白对高血压早期肾损害的诊断价值

Diagnostic value of serumα1,β2 microglobulin,cystatin C and urinary microprotein in early renal damage of hypertension

目的探讨血α1微球蛋白(α1-MG)、β2微球蛋白(β2-MG)、胱抑素C(Cys C)及尿微量蛋白(mALb)对高血压早期肾损害的诊断价值。方法选择2018年1月至2020年3月本院收治的60例高血压患者为高血压组,60例高血压早期肾病患者为高血压肾病组,60例健康体检者为对照组。比较3组血α1-MG、β2-MG、Cys C和尿mALb水平,分析血α1-MG、β2-MG、Cys C和尿mALb单一和联合检测高血压早期肾病的价值。结果高血压肾病组血α1-MG[(41.78±12.26)mg/L]、β2-MG[(4.60±1.27)mg/L]、Cys C[(1.35±0.32)mg/L]及尿mALb[(80.74±10.49)mg/L]含量高于高血压组、对照组,高血压组血上述指标含量高于对照组,差异均有统计学意义(F分别为24.687、22.186、17.964、36.417,均P<0.05)。血α1-MG、β2-MG、Cys C及尿mALb联合诊断高血压早期肾病的敏感度(95.00%)高于Cys C(83.33%)、β2-MG(68.33%)、α1-MG(61.67%),特异度(96.67%)高于α1-MG(86.67%)、β2-MG(80.00%)、mALb(76.67%),准确度(95.83%)高于血α1-MG(74.17%)、β2-MG(74.17%)、Cys C(87.50%)及尿mALb(80.83%)单一诊断,差异均有统计学意义(均P<0.05)。结论血α1-MG、β2-MG、Cys C和尿mALb均是诊断高血压早期肾病的有效指标,上述指标联合诊断能够提高疾病检出率。

Objective This study was designed to explore the diagnostic value ofα1-MG,β2-MG,Cys C and mALb in early renal damage of hypertension.Methods From January 2018 to March 2020,60 patients with hypertension were se-lected as hypertension group,60 patients with early hypertensive nephropathy as hypertensive nephropathy group,and 60 healthy people as control group.We compared the levels ofα1-MG,β2-MG,Cys C and urine mALb in three groups,and analyzed the value of single and combined detection ofα1-MG,β2-MG,Cys C and urine mALb in early hypertensive ne-phropathy.Results Bloodα1-MG[(41.78±12.26)mg/L],β2-MG[(4.60±1.27)mg/L],Cys C[(1.35±0.32)mg/L]and urine mALb[(80.74±10.49)mg/L]in hypertensive nephropathy group were higher than those of the hyper-tension group and the control group,and the contents of the above indexes in the blood of the hypertension group were high-er than those of the control group,with statistical significance(F=24.687,22.186,17.964,36.417,respectively,P<0.05).The sensitivity(95.00%)ofα1-MG,β2-MG,Cys C and urine mALb in the diagnosis of early hypertensive ne-phropathy were higher than Cys C(83.33%),β2-MG(68.33%),andα1-MG(61.67%);Specificity(96.67%)was higher thanα1-MG(86.67%),β2-MG(80.00%),mALb(76.67%),and accuracy(95.83%)was higher than bloodα1-MG(74.17%),β2-MG(74.17%),Cys C(87.50%)and urine mALb(80.83%)diagnosed by single diagnosis,with the difference being statistically significant(all P<0.05).Conclusion Serumα1-MG,β2-MG,Cys C and urine mALb are all effective indicators for the diagnosis of early hypertensive nephropathy.Combined diagnosis can improve the detection rate of diseases and guide the treatment.