【摘要】 目的探讨原发性高血压早期肾损害患者检测血清胱抑素C(CysC)、同型半胱氨酸(Hcy)的临床意义。方法选择巨野县人民医院于2015年2月~2016年8月收治的原发性高血压患者120例,男性71例,女性49例。将肾小球滤过率(GFR)≥80 ml/(min·1.73 m2)患者纳入高血压组(62例);将GFR<80 ml/(min·1.73 m~2)患者纳入早期肾损害组(58例);同期纳入健康体检者作为健康组(60例),既往无急慢性疾病史。检测患者入院时和健康组体检时血清CysC及Hcy水平。测定入院时的肾小球滤过率。CysC(>1.1 mg/L)、Hcy(>15μmol/L)诊断为早期肾损害。结果健康组、高血压组、早期肾损害组血清CysC、Hcy水平均呈升高趋势,差异有统计学意义(P均<0.05)。单项CysC、Hcy检测的阳性率低于CysC联合Hcy检测,69.0%vs.94.8%,63.8%vs.94.8%,差异有统计学意义(P均<0.05)。原发性高血压早期肾损害患者GFR与血清CysC、Hcy水平均呈负相关,相关系数分别为-0.576、-0.341(P均<0.05)。结论血清胱抑素C及同型半胱氨酸联合检测有利于原发性高血压早期肾损害的诊断,指导临床治疗。更多还原

【Abstract】 Objective To investigate the clinical significance of detection of serum cystatin C(CysC) combining homocysteine(Hcy) in patients with early renal damage induced by primary hypertension.MethodsThe patients with primary hypertension(n=120,male 71 and female 49) were chosen from the People’s Hospital of Juye County from Feb.2015 to Aug.2016.The patients with glomerular filtration rate(GFR)≥80 ml/(min·1.73 m~2) were chosen into hypertension group(n=62),those with GFR<80 ml/(min·1.73 m~2),into early renal damage group(n=58),and the same term health controls,into health group(n=60).The levels of CysC and Hcy were detected when patients hospitalized and health controls with physical examinations.GFR was detected in all groups at hospitalization time.The early renal damage could be diagnosed when CysC>1.1 mg/L and Hcy>15 μmol/L.Results The levels of CysC and Hcy showed an ascending trend in all 3 groups(all P<0.05).The positive rate of single CysC detection or single Hcy detection was lower than that of detection of CysC combining Hcy(69.0% vs.94.8%;63.8% vs.94.8%,all P<0.05).GFR was negatively correlated to the levels of serum CysC and Hcy(r=-0.576;r=-0.341,all P<0.05) in patients with early renal damage induced by primary hypertension.ConclusionThe combined detection of CysC and Hcy is beneficial to the diagnosis of early renal damage induced by primary hypertension,and can be used for guiding clinical treatment.更多还原