摘要
目的评价高血压患者尿素(Urea)、肌酐(Cr)、β2-微球蛋白(β2-MG)、视黄醇结合蛋白(RBP)和胱抑素C(Cystatin C,Cys-C)等五项肾功能指标对早期肾损害的临床诊断价值。方法使用全自动生化分析仪对316例高血压患者和60例正常人血清中五项肾功能指标进行检测,并对检测结果进行统计学分析。结果尿蛋白阴性的高血压病患者组血Urea和Cr浓度与正常对照组比较无显著差异(P>0.05),而β2-MG、、RBP和Cys-C浓度与对照组比较差异有显著性(P<0.01),其AUC分别为0.736、0.748、0.866,在各最佳截断点的灵敏度和特异度分别为62.7%、66.8%、73.7%和89.2%、90.8%、93.5%。在诊断高血压患者早期肾损害中联合检测较单项指标阳性率高,以联合检测β2-MG、RBP和Cys-C这三项肾功能指标组阳性率最高,达90.2%,明显高于二项联合检测80.4%(χ2=4.96,P<0.05)。结论五项肾功能指标对高血压早期肾损害的有较好的相关性,联合检测有较高的检出率、灵敏度、特异度及诊断符合度,对高血压肾病的早期诊断有重要的临床价值,适合在临床工作中推广使用。
Objective To evaluate the clinical diagnostic value of combined detection of serum urea,creatinine（Cr）,β2-microglobulin（β2-MG）,retinol binding protein（RBP） and cystatin C（Cys-C） for early renal Dysfunction of Hypertension.Methods The levels of five indices of kidney function mentioned above in 316 patients with hypertension and 60 healthy control subjects were detected by automatic chemistry analyzer,and then analyzed the data statistically.Results The levels of serum urea and Cre had no significant difference between the healthy control and the patients of hypertension whose urine protein was negative（P0.05）,Whileβ2-MG、 RBP and Cys-C levels in those patients were significantly higher than them in the control group（P0.01）.And the AUC of the three indices were respectively 0.736,0.748,0.866;the sensitivities of them in the best truncation points were 62.7%、66.8% and 73.7%,the specificities corresponding to them were 89.2%、90.8% and 93.5%.Moreover,to diagnose the early renal damage of hypertension,combined determination was better than the single one.Especially combined with β2-MG、RBP and Cys-C,the positive rate of such the combined detection was 90.2%,If combined with any of the two of the three indices,the highest positive rate was just 80.4%（χ2=4.96,P0.05）,obviously lower than 90.2%.So we can see that,the combination with three indices was the best choose.Conclusion There is good correlation among the five indices of kidney function in diagnosing the early renal damage of hypertension.Combined determination is helpful for diagnosis and assessment of early renal dysfunction of hypertension,because of its high detection rate,sensitivity,specificity as well as its high diagnosis accorded degrees,in a word,it is suitable to promote in the clinical category.
出处
《中国医药指南》
2012年第31期21-23,共3页
Guide of China Medicine
