四项指标联合检测在肾脏疾病早期诊断中的应用  

The Diagnostic Value of Combined Detection of Four Indexes in Patients With Early Kidney Disease

作　　者：曾秀雅[1] 陈海明[1] 王燕凤 

机构地区：[1]厦门大学附属第一医院检验科,福建厦门361000

出　　处：《中国卫生标准管理》2017年第23期119-122,共4页China Health Standard Management

摘　　要：目的通过对血清胱抑素C(Cys C)、尿素氮(BUN)、肌酐(CRE)及尿微量白蛋白(Um Alb)的联合检测,探讨在早期肾脏疾病中的应用价值。方法选取2016年6月—2017年5月在我院肾内科就诊的门诊及住院患者150例患者为肾脏疾病组,另外选取150例临床上排除了原发及继发肾脏疾病的患者为其他疾病组。同时选取同期在我院健康体检者150例为对照组。分别对三组进行Um Alb、血清中的Cys C、BUN、CRE含量的检测,并进行各个标志物与肾脏损伤的相关性比较。结果肾脏疾病组Um Alb、血清Cys C、BUN、CRE水平均明显高于其他疾病组、健康对照组,差异有统计学意义(P<0.05)。血清Cys C、Um Alb的敏感性和特异性分别为(85.8%,94.3%)和(83.2%,92.2%),均明显高于BUN、CRE。ROC曲线AUC值显示Cys C、Um Alb与早期肾脏疾病诊断相关性好。结论血清Cys C、Um Alb能更敏感、特异地反映早期肾脏损伤,是早期肾脏疾病理想的诊断指标。通过与BUN、CRE指标联合检测可提高早期诊断的灵敏度和特异度。Objective To explore the clinical values of combinend measurement of serum CysC（CysC）,serum urea nitrogen（BUN）,serum creatinine（CRE）,urinary microalbumin（UmAlb）in patients with（early）kidney disease. Methods From August 2016 to July 2017, 150 hospitalized and outpatients with early kidney disease were divided into the kidney disease group, 150 patients who without kidney disease were divided into the other disease group, 150 healthy persons were named as the control group. The serum level of CysC, BUN, CRE and UmAlb were detected and analyzed. Results There were statistically significant differences in the levelof serum CysC, BUN, CRE and UmAlb（P 0.05）compared to other disease group and health group. The sensitivity and specificity of CysC（85.8%, 94.3%） and UmAlb（83.2%, 92.2%） were more higher than BUN, CRE. The area under the ROC curve（AUC）showed CysC and UmAlb well relevance to with early kidney disease.Conclusion The serum CysC and UmAlb can be more sensitive to specifically reflect the early kidney damage. They are ideal diagnostic indicators of early kidney disease. The combination of BUN and CRE can improve sensitivity and specificity.

关 键 词：尿微量白蛋白 血清胱抑素C 尿素氮 肌酐 早期肾脏疾病 

分 类 号：R587[医药卫生—内分泌]