【摘要】 目的评估内生肌酐清除率(Ccr),血清肌酐(SCr)、尿素氮(Urea)、半胱氨酸蛋白酶抑制剂C(s-Cys-C)、视黄醇结合蛋白(s-RBP),尿液微量总蛋白(u-Pro)、微量清蛋白与肌酐比值(u-Alb/Cr)、视黄醇结合蛋白(u-RBP)、半胱氨酸蛋白酶抑制剂C(u-Cys-C)、N-乙酰-β-D-氨基葡萄糖苷酶(u-NAG)等项目诊断慢性肾衰竭(CRF)的临床价值,寻找合适、有效的组合以提高CRF诊断率。方法选择住院患者206例,分别检测SCr、Urea、s-Cys-C、s-RBP、u-Pro、u-Alb/Cr、u-RBP、u-Cys-C、u-NAG等,计算Ccr值;联合检测分别为双项目和四项目组合。应用Excel软件和SPSS19.0统计软件对数据进行分析。结果 s-Cys-C的约登指数(YI)为0.59,受试者工作特征(ROC)曲线下面积为0.872,在单项目检测中均最高。SCr和s-Cys-C双项目并联试验的YI(0.60)最高,Urea、SCr、s-RBP、s-Cys-C四项目串联试验的阳性预测值(100.00%)最高,u-RBP和u-Cys-C双项目并联试验的阴性预测值(100.00%)最高。结论联合检测更有利于CRF的诊断,其中SCr和s-Cys-C双项目联合检测对CRF的诊断最有价值。s-CysC单项目检测拥有较合适的灵敏度和特异性,诊断效率较其他项目高。排除肾功能损伤可选择联合检测u-RBP和u-Cys-C,且具有无创伤性、取样方便等优势。更多还原

【Abstract】 Objective To evaluate the clinical values of endogenous creatinine clearance rate(Ccr),serum creatinine(SCr),urea nitrogen(Urea),serum cystatin C(s-Cys-C),serum retinol binding protein(s-RBP),Urine total protein(u-Pro),urine albumin and creatinine ratio(u-Alb/Cr),urine RBP(u-RBP),urine Cys-C(u-Cys-C),u-NAG and et al in the diagnosis of chronic renal failure(CRF),find suitable and effective detection combinations to increase the diagnostic accuracy of CRF.Methods SCr,Urea,s-Cys-C,s-RBP,u-Pro,u-Alb/Cr,u-RBP,u-Cys-C,u-NAG were detected respectively in 206 hospitalized patients and Ccr values were calculated at the same time.By using Excel and SPSS19.0softwares,the data were analysed.Combined detections included two and four items combined detections.Results Youden index(YI)of serum Cys-C was 0.59.Area under the curve in the receiver operating characteristic(ROC)of Cys-C was 0.872 which was the highest of all the single detection items.Combined detection of SCr and sCys-C got the highest YI(0.60).Combination of four items(Urea,SCr,s-RBP,s-Cys-C)had the highest positive predictive value(100.00%).Combination of u-RBP and u-Cys-C had the highest negative predictive value(100.00%).Conclusion Combined detection was more favorable for CRF diagnosis.Combination detection of SCr and s-Cys-C was the most valuable detection for the diagnosis of CRF.Among single item detections,s-Cys-C detection had better sensitivity and specificity,and diagnostic efficiency than other detection items.U-RBP and u-Cys-C could be used to exclude renal impairment due to its noninvasive sampling.更多还原