【摘要】 目的探讨检测血清胱抑素-C(CysC)、肌酐(Cr)和同型半胱氨酸(Hcy)用于临床诊断早期高血压肾病的临床价值。方法选取浦东新区联洋社区卫生服务中心2016年3月—2017年8月收治的100例高血压患者,按照其肾小球滤过率将其分为甲、乙和丙三组,其中,甲组为单纯性高血压30例,乙组为高血压肾病I~II期35例,丙组为高血压肾病III~IV期35例。另选取同期进行健康体检的健康人群40例作为本次研究的对照组。分别于空腹下抽取各组静脉血液3 ml检测血清CysC、Hcy和Cr水平,并比较各单独指标与联合检测间诊断的准确性。结果甲组患者血清CysC、Cr水平与对照组相比较,P>0.05;乙组、丙组与对照组血清CysC、Cr水平相比较,P<0.05。甲组、乙组和丙组与对照组血清Hcy水平相比较,P<0.05。检测血清Hcy、Cr诊断准确率明显高于单独检测血清CysC,P<0.05;丙组中,单独检测血清CysC、Hcy和Cr对其诊断准确率无明显差异,P>0.05。检测血清Hcy、Cr诊断准确率明显高于单独检测血清CysC(χ2=6.85、χ2=5.71,P<0.05);丙组中,单独检测血清CysC、Hcy和Cr对其诊断准确率无明显差异,F=1.02,P=0.36。乙组中,检测血清CysC、Hcy的诊断阳性率相比较(χ2=0.28、χ2=0.59),明显高于检测血清Cr阳性率(χ2=4.71,6.98,P<0.05)。结论血清CysC、Hcy和Cr为高血压肾病患者的重要生化指标,可作为临床诊断的参考指标,检测血清CysC、Hcy对诊断早期高血压肾病具有较高诊断价值。更多还原

【Abstract】 OBJECTIVE To investigate the clinical value of serum cystatin C(Cys-C), creatinine(Cr) and homocysteine(Hcy) in the di-agnosis of early hypertensive nephropathy. METHODS From March 2016 to August 2017 100 cases of hypertensive patients were se-lected from the target hospital according to their glomerular filtration rate was divided into three groups, three groups, including agroup of simple hypertension, 30 cases, the group B is high I~II stage of blood pressure nephropathy, 35 cases, group C hypertensivenephropathy III ~ IV period, 35 cases. During the same period, 40 healthy people in target hospital were selected as the study controlgroup. The levels of CysC, Hcy and Cr in serum of 3 ml venous blood of each group were measured under fasting, and the diagnosticaccuracy of each individual index and the combination test was compared. RESULTS Serum levels of CysC and Cr in group A weresignificantly higher than those in control group(P>0.05). Serum levels of CysC and Cr in group B, group C were significantly lowerthan those in control group(P<0.05). Group A, Group B, Group C and control serum Hcy levels compared, P<0.05. Serum Hcy, Crdiagnostic accuracy was significantly higher than the single test serum Cys-C, P<0.05; C group, single detection of serum CysC,Hcy, Cr diagnostic accuracy had no significant difference, P>0.05. Serum Hcy, Cr diagnostic accuracy was significantly higher thanthe single detection of serum Cys-C(χ~2=6.85,χ2=5.71, P<0.05); C group, single detection of serum CysC, Hcy, Cr diagnostic accu-racy was no significant difference, F=1.02, P=0.36. In group B, the positive rate of serum CysC and Hcy was higher than that of se-rum CysC(χ~2=0.28,χ~2=0.59), but it was significantly higher than the positive rate of serum Cr(χ~2=4.71,6.98, P<0.05). CONCLUSION Serum CysC, Hcy, Cr is an important biochemical index in patients with hypertensive nephropathy, it could be used as a refer-ence for clinical diagnosis, while the detection of serum CysC, Hcy on the diagnosis of early hypertensive nephropathy had a high di-agnostic value.更多还原