同型半胱氨酸、血清胱抑素C、尿微量清蛋白联合检测在高血压早期肾损伤中的诊断价值

Diagnostic value of homocysteine,serum cystatin C and urinary microalbumin combined detection in early hypertensive renal injury

目的探究同型半胱氨酸(Hcy)、血清胱抑素C(CysC)、尿微量清蛋白(U-mALB)联合检测在高血压早期肾损伤中的诊断价值。方法回顾性选取2018年3月至2020年3月曲靖市第一人民医院收治的80例高血压早期肾损伤患者作为实验组,另选取同期于本院健康体检者80名作为对照组。两组均进行血清Hcy、CysC、U-mALB检测。比较两组血清Hcy、CysC、U-mALB水平及血清Hcy、CysC、U-mALB单一检测和联合检测的诊断效能,分析血清Hcy、CysC、U-mALB之间的相关性。结果实验组血清Hcy、CysC、U-mALB水平均高于对照组,差异有统计学意义(P<0.05)。108例为阳性,52例为阴性。联合检测(任一指标阳性、均为阳性)的特异度、灵敏度、准确率均高于Hcy、CysC、UmALB单一检测,差异有统计学意义(P<0.05)。Pearson相关分析显示,Hcy与CysC、U-mALB呈正相关(r=0.641、0.724,P=0.002、0.003);CysC与U-mALB呈正相关(r=0.609,P=0.002)。结论高血压早期肾损伤患者血清Hcy、CysC、U-mALB水平呈高表达,血清Hcy、CysC、UmALB联合检测诊断高血压早期肾损伤的诊断中准确率、灵敏度及特异度均较高,整体诊断价值较高,可为临床辅助诊断和治疗提供参考。

Objective To explore the diagnostic value of combined detection of homocysteine(Hcy),serum cystatin C(CysC),and urinary microalbumin(U-mALB)in early renal injury in patients with hypertension.Methods 80 patients with early renal injury due to hypertension admitted to the First People's Hospital of Qujing City from March 2018 to March 2020 were spectively selected as the experimental group,and 80 healthy individuals who underwent physical examination in our hospital during the same period were selected as the control group.Fresh morning urine was taken from all subjects for protein qualitative analysis,and serum levels of Hcy,CysC,and U-mALB were measured.Serum Hcy,CysC and UmALB levels were compared between the two groups,the diagnostic efficacy of single detection and combined detection of serum Hcy,CysC and UmALB was compared,and the correlation between serum Hcy,CysC and U-mALB was analyzed.Results The levels of serum Hcy,CysC,and UmALB in the experimental group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).108 cases of the 160 cases patients were positive and 52 were negative.The specificity,sensitivity and accuracy of combined detection(positive or positive for any index)were higher than those of single detection of Hcy,CysC and U-mALB,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that Hcy was positively correlated with CysC and U-mALB(r=0.641,0.724,P=0.002,0.003).CysC was positively correlated with U-mALB(r=0.609,P=0.002).Conclusion Serum Hcy,CysC and U-mALB levels were highly expressed in patients with early hypertensive renal injury.The combined detection of serum Hcy,CysC and U-mALB had high accuracy,sensitivity and specificity in the diagnosis of early hypertensive renal injury,and had high overall diagnostic value,which could provide reference for clinical auxiliary diagnosis and treatment.