血清同型半胱氨酸和胱抑素C检测在慢性心力衰竭患者早期肾损伤诊断中的应用

Application of serum homocysteine and cystatin C testings in the diagnosis of early renal injury in patients with chronic heart failure

目的:探讨血清同型半胱氨酸(Hcy)与胱抑素C(Cys-C)在慢性心力衰竭(CHF)患者早期肾损伤诊断中的应用价值。方法:回顾性抽取2022年1月至2024年1月新乡市中心医院收治的102例CHF患者进行研究,均检测肾小球滤过率(GFR)、Hcy及Cys-C水平。以GFR诊断结果作为标准判断是否伴有早期肾损伤,伴有早期肾损伤则为阳性(阳性组),未伴有早期肾损伤则为阴性(阴性组)。分析阳性组与阴性组GFR、Hcy及Cys-C水平,分析Hcy、Cys-C及二者联合诊断CHF患者早期肾损伤的诊断效能。结果:以GFR为诊断标准,确诊伴有早期肾损伤42例(阳性),未伴有早期肾损伤60例(阴性)。阳性组与阴性组GFR、Hcy及Cys-C水平比较差异均有统计学意义(P均<0.05)。Hcy诊断检出阳性33例,阴性69例;Cys-C诊断检出阳性34例,阴性68例;二者联合诊断检出阳性40例,阴性62例。Hcy联合Cys-C诊断CHF患者早期肾损伤的准确度与灵敏度(94.12%,96/102;90.47%,38/42)均高于Hcy(79.41%,81/102;64.28%,27/42)及Cys-C(78.43%,80/102;64.28%,27/42)单一诊断(P均<0.05)。结论:CHF伴早期肾损伤患者血清Hcy及Cys-C水平高于单纯CHF患者,二者可作为诊断CHF患者早期肾损伤的辅助指标,但与单一诊断比较,二者联合诊断用于CHF早期肾损伤患者中可进一步提高诊断效能。

Objective:To investigate the application value of serum homocysteine(Hcy)and cystatin C(Cys-C)in the diagnosis of early renal injury in patients with chronic heart failure(CHF).Methods:A total of 102 CHF patients admitted to Xinxiang Central Hospital from January 2022 to January 2024 were retrospectively selected for analysis.The levels of glomerular filtration rate(GFR),Hcy and Cys-C in all selected patients were detected.GFR diagnostic results were considered as the standard to judge the occurrence of early renal injury:patients with early renal injury as positive(positive group),and patients without early renal injury as negative(negative group).The levels of GFR,Hcy and Cys-C in the positive group and the negative group were analyzed,and the diagnostic efficacy of Hcy,Cys-C and combination of them for early renal injury in patients with CHF were calculated and compared.Results:Taking the GFR as the diagnostic criteria,42 cases were diagnosed with early renal injury(positive)and 60 cases were diagnosed with non-early renal injury(negative).There were significant differences in levels of GFR,Hcy and Cys-C between the positive group and the negative group(all P<0.05).Hcy testing detected out 33 positive cases and 69 negative cases;Cys-C testing detected out 34 positive cases and 68 negative cases;while Hcy combined with Cys-C testing detected out 40 positive cases and 62 negative cases.The accuracy and sensitivity of Hcy combined with Cys-C in diagnosing early renal injury in CHF patients(94.12%,96/102;90.47%,38/42)were higher than those of Hcy alone(79.41%,81/102;64.28%,27/42)and Cys-C alone(78.43%,80/102;64.28%,27/42),all P<0.05.Conclusions:CHF patients with early renal injury have higher expressions of serum Hcy and Cys-C compared with patients with CHF alone,and the two indicators can be used as auxiliary indicators for the diagnosis of early renal injury in CHF patients.Compared with single indicator diagnosis,the combination of Hcy and Cys-C in patients with early renal injury in CHF can further improve the diagnostic efficiency.