肌钙蛋白等多指标在不同程度肾损害人群中的意义探讨  

作　　者：刘飞[1] 金海甲[1] 栾静[1] 周静姝[1] 丁雪峰[1] 

机构地区：[1]吉化集团公司总医院(北华大学第二附属医院)检验科,吉林132021

出　　处：《当代医学》2015年第35期62-64,共3页Contemporary Medicine

摘　　要：目的探讨心肌肌钙蛋白以及血清胱抑素C等多指标在不同程度肾损害分组人群中的含量变化,特别关注传统心肌损伤标志物c Tn T和c Tn I在肾脏损害时的判断价值和意义。方法分别对体检职工300例、糖尿病无合并肾病患者50例、糖尿病肾病患者50例、肾内科患者50例和血液透析科患者60例测定各项指标并对数据进行分析,对大部分病例在第2年进行复检再次分析。结果血清胱抑素C联合尿微量白蛋白及尿β_2微球蛋白检测对早期肾损害检出率可达90%以上,c Tn T和c Tn I在肾损害加重过程中有升高趋势,尤其在透析患者中比例分别达到20%和15%。透析对c Tn T和c Tn I影响不明。c Tn T异常其他指标正常的患者,后续发生肾损害的概率比肌钙蛋白正常组高。c Tn I异常的患者,后续心血管事件发生率高于c Tn I正常组。以上差异均有统计学意义(P<0.05)。结论血清胱抑素C联合尿微量白蛋白及尿β_2微球蛋白检测早期肾损害检出率优于传统肾功指标。肾损害加重时,肌钙蛋白,尤其c Tn T有升高趋势,c Tn T和c Tn I分别对后续肾病发生和心血管事件有较好的预测作用。Objective To discuss the content change of cTnT（Cardiac troponin T）,cTnI（Cardiac troponin I）,Cys C（Cystein C） and many other examination indicators in people of different groups of kidney damage, especially focusing on the judge value and clinical value of classic myocardial damage indicators, cTnT and cTnI when there is kidney damage. Methods To make a collection of specimen from healthy people （n=300） diabetics （n=50）, diabetic nephropathy （n=50）,patients from urology department （n=50） and hemodialysis （n=60）, doing tests and analyzing the data, then repeated in the next year to most examples. Results We can have over 90% positive rate when Cys C goes with malb and 132-MG in detecting kidney damage, the content of cTnT and cTnI has a upward trend during the aggravation. The proportion is 20% and 15% respectively in dialysis, which has no definite effect on cTnT and cTnl.For those with higher level of cTnT when other indicators are normal, chances are more that they will have kidney damage.For those with higher level of eTnI, cardiovascular events are met more in the future.All the data showed statistical difference（P〈0.05）. Conclusion The positive rate of Cys C together with malb and 13 2-MG is better than traditional indicators in finding early kidney damage. The content of cTnT and cTnI has a upward trend during the aggravation of kidney damage.cTnT and cTnI has a good value in predicting kidney damage and cardiovascular events rest）ectivelv.

关 键 词：肾损害 心肌肌钙蛋白T/I 血清胱抑素C 

分 类 号：R692[医药卫生—泌尿科学]