尿微量清蛋白、脂蛋白-a、胱抑素C联合检测在高血压肾病诊断中的价值  

Value of combined detection of urinary microalbumin,lipoprotein-a and cystatin C for diagnosing hypertensive nephropathy

作　　者：冉新胜 杨兵 姜小建[2] RAN Xinsheng;YANG Bing;JIANG Xiaojian(Department of Clinical Laboratory,Yanliang District People′s Hospital,Xi′an,Shaanxi 710089,China;Department of Clinical Laboratory,Xi′an Municipal Central Hospital,Xi′an,Shaanxi 710003,China)

机构地区：[1]陕西省西安市阎良区人民医院检验科,陕西西安710089 [2]陕西省西安市中心医院检验科,陕西西安710003

出　　处：《检验医学与临床》2020年第10期1407-1409,1413,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨尿微量清蛋白(U-mALB)、脂蛋白-a(Lp-a)、胱抑素C(Cys C)联合检测对高血压肾病的诊断价值。方法选取2016年5月至2017年10月西安市中心医院收治的高血压肾病患者30例(观察组)、高血压肾功能正常患者30例(对照组)为研究对象,另外选取同期到西安市中心医院体检的健康体检者30例(健康组)为研究对象。比较各组研究对象U-mALB、Lp-a和Cys C的水平及各指标的诊断价值。结果各组研究对象U-mALB、Lp-a和Cys C的水平和阳性率差异均有统计学意义(P<0.05),且观察组U-mALB、Lp-a和Cys C的水平和阳性率均明显高于对照组和健康组(P<0.05),对照组U-mALB、Lp-a和Cys C的水平和阳性率明显高于健康组(P<0.05)。U-mALB、Lp-a和Cys C的曲线下面积(AUC)均大于0.7且处于95%置信区间范围内。U-mALB、Lp-a和Cys C单项及联合检测中AUC最大的是U-mALB+Lp-a+Cys C,其AUC为0.895,灵敏度为90.08%,特异度为92.36%,阳性预测值为89.50%。结论U-mALB、Lp-a和Cys C联合检测对高血压肾病的诊断具有重要意义。Objective To investigate the diagnostic value of combined detection of urinary microalbumin(U-mALB),lipoprotein-a(Lp-a)and cystatin C(Cys C)in hypertensive nephropathy.Methods Thirty cases of hypertensive nephropathy(observation group),30 cases of hypertension with normal renal function(control group)and contemporaneous 30 healthy persons undergoing the physical examination in the Xi′an Municipal Central Hospital from May 2016 to October 2017 were selected as the study subjects.The levels of U-mALB,Lp-a and Cys C and their diagnostic values were compared among the various groups.Results The differences in the levels and positive rates of U-mALB,Lp-a and Cys C among the three groups had statistical significance(P<0.05),moreover the levels and positive rates of these three indicators in the observation group were significantly higher than those in the control group and the healthy group(P<0.05),and the levels and positive rates of the indicators in the control group were significantly higher than those in the healthy group(P<0.05).The area under the curve(AUC)of U-mALB,Lp-a and Cys C was>0.7 and within 95%confidence interval.In the single and combined detections of U-mALB,Lp-a and Cys C,the maximal AUC was U-mALB+Lp-a+ Cys C,AUC of U-mALB+ Lp-a+ Cys C was 0.895,the sensitivity was 90.08%,the specificity was 92.36% and the positive predictive value was 89.50%.Conclusion The combined detection of U-mALB,Lp-a and Cys C has an important significance in the diagnosis of hypertensive nephropathy.

关 键 词：尿微量清蛋白 脂蛋白-a 胱抑素C 高血压肾病 

分 类 号：R446.1[医药卫生—诊断学]