高血压早期肾损害诊断指标的筛选OA北大核心CSTPCD
Screening of diagnostic indicators for early renal damage in patients with hypertension
目的:筛选高血压早期肾损害的诊断指标.方法:搜集2020 年1 月至2023 年2 月河南省人民医院内科病房收治的高血压患者,选取高血压早期肾损害[30 mg/24 h≤尿白蛋白排泄率(uAER)<300 mg/24 h]患者51 例(肾损害组),以及单纯高血压患者51 例(对照组).比较两组患者血清尿素氮(BUN)、肌酐(SCr)、同型半胱氨酸(HCY)、视黄醇结合蛋白(RBP)、胱抑素C(CysC)、尿微量白蛋白(umALB)、微量白蛋白/肌酐比值(uACR)、α1 微球蛋白(uα1MG)、β2 微球蛋白(uβ2MG)、N-乙酰-β-D氨基葡萄糖苷酶(uNAG)及转铁蛋白(uTF)水平的差异.绘制ROC曲线,比较上述指标对高血压早期肾损害的诊断效能.结果:肾损害组患者血清BUN、SCr、HCY、RBP、CysC水平及umALB、uAER、uACR、uα1MG、uβ2MG、uNAG、uTF水平均高于对照组(P均<0.05).ROC曲线AUC>0.9的指标从高到低分别为uACR>CysC>uα1MG>uβ2MG>umALB>RBP,其中CysC+uACR联合诊断的效能和敏感度最高[AUC(95%CI)为0.994(0.954～1.000),敏感度为1.000].结论:CysC+uACR为高血压患者早期肾损害的高效诊断指标.
Aim:To screen diagnostic index of early renal damage in patients with hypertension.Methods:From Janu-ary 2020 to February 2023,hypertensive patients admitted to the Department of Internal Medicine of Henan Provincial Peo-ple's Hospital were chosen.Fifty-one hupertension patients with early renal damage[30 mg/24 hour≤urinary albumin ex-cretion rate(uAER)<300 mg/24 hour](renal damage group),and 51 patients with simple hypertension(control group)were selected.ROC curve was drawn to compare the diagnostic efficacy of serum urea nitrogen(BUN),serum creatinine(SCr),serum homocysteine(HCY),serum retinol-binding protein(RBP),serum cystatin C(CysC),urinary microalbumin(umALB),urinary microalbumin/creatinine ratio(uACR),urinary α1 microglobulin(uα1MG),urinary β2 microglobulin(uβ2MG),urinary N-acetyl-β-D glucosaminidase(uNAG),and urinary transferrin(uTF).Results:The levels of indexes(BUN,SCr,HCY,RBP,CysC,umALB,uAER,uACR,uα1MG,uβ2MG,uNAG,uTF)in renal damage group were signifi-cantly higher than those in control group(all P<0.05);the order of diagnostic efficacy(AUC>0.9)from high to low was as follows:uACR>CysC>uα1MG>uβ2MG>umALB>RBP.Combination of CysC and uACR had the highest diagnostic efficiency[AUC(95%CI)was 0.994(0.954-1.000),sensitivity rate of 1.000].Conclusion:Combination of CysC and uACR has higher diagnostic efficacy of early renal damage in patients with hypertension.
孔德慧;刘敏
河南省人民医院高血压科 郑州 450000
临床医学
高血压肾损害肾功能24h尿白蛋白排泄率血清胱抑素C尿微量白蛋白/肌酐比值
hypertensionkidney damagekidney function24 hour urinary albumin excretion rateserum cystatin Curinary microalbumin/creatinine ratio
《郑州大学学报（医学版）》 2024 (003)
376-380 / 5
河南省医学科技攻关计划项目(LHGJ20220002);国家自然科学基金面上项目(82270463)
评论