肾病患者红细胞沉降率异常增快诊断继发性肾脏疾病的效能  

Efficacy analysis of abnormal increase of erythrocyte sedimentation rate on diagnosis of secondary renal diseases in nephrotic patients

作　　者：王严 白静 高雅楠 雷学峰 Wang Yan;Bai Jing;Gao Yanan;Lei Xuefeng(Department of Nephrology,Affiliated Hospital of Gansu Medical College,Gansu Province,Pingliang 744000,China;Department of Cardiovascular Medicine,Affiliated Hospital of Gansu Medical College,Gansu Province,Pingliang 744000,China;the 12th Ward,Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Department of Hematology,Affiliated Hospital of Gansu Medical College,Gansu Province,Pingliang 744000,China)

机构地区：[1]甘肃医学院附属医院肾病内科,甘肃省平凉市744000 [2]甘肃医学院附属医院心血管内科,甘肃省平凉市744000 [3]首都医科大学附属北京安贞医院心内十二病房,100029 [4]甘肃医学院附属医院血液病科,甘肃省平凉市744000

出　　处：《中国医药》2020年第10期1590-1593,共4页China Medicine

摘　　要：目的探讨肾病患者红细胞沉降率(ESR)异常增快诊断继发性肾脏疾病的效能。方法选择2018年1月至2019年12月在甘肃医学院附属医院住院的原发性肾小球疾病患者40例(原发性肾小球疾病组)和继发性肾脏疾病患者40例(继发性肾脏疾病组)。比较2组患者的一般临床资料,分析ESR诊断继发性肾脏疾病的效能。结果原发性肾小球疾病组血红蛋白水平明显高于继发性肾脏疾病组[(128±29) g/L比(113±32) g/L],差异有统计学意义(P <0.05)。继发性肾脏疾病组ESR水平明显高于原发性肾小球疾病组[42(16,94) mm/1 h比16(10,27) mm/1 h],差异有统计学意义(P <0.001)。ESR诊断继发性肾脏疾病的曲线下面积为0.747(95%置信区间:0.638-0.856),敏感度为0.675、特异度为0.775,最大约登指数为0.45,截断值为27.5 mm/1 h,95%特异度原则下截断值为69.8-82.0 mm/1 h。结论肾病患者ESR异常增快(> 82.0 mm/1 h)可诊断继发性肾脏疾病。Objective To investigate the efficacy of abnormal increase of erythrocyte sedimentation rate(ESR)on diagnosis of secondary renal diseases in nephrotic patients.Methods From January 2018 to December2019,40 patients with primary glomerular diseases(primary glomerular disease group)and 40 patients with secondary renal diseases(secondary renal disease group)were selected from the Affiliated Hospital of Gansu Medical College.The general clinical data and ESR level of the two groups were compared to analyze the efficacy of ESR in diagnosing secondary renal diseases.Results The hemoglobin level in primary glomerular disease group was higher than that in secondary renal disease group[(128±29)g/L vs(113±32)g/L](P<0.05).ESR level in secondary renal disease group was higher than that in primary glomerular disease group[42(16,94)mm/1 h vs16(10,27)mm/1 h](P<0.001).The area under curve of ESR was 0.747(95%confidence interval:0.638-0.856),the sensitivity was 0.675,the specificity was 0.775,the most approximate ascending index was 0.45,and the best truncation value was 27.5 mm/1 h.The truncation value under the 95%specificity principle was69.8-82.0 mm/1 h.Conclusion Abnormal ESR increase(>82.0 mm/1 h)in nephrotic patients can be used to diagnose secondary chronic kidney disease.

关 键 词：肾脏损伤 继发性肾脏疾病 红细胞沉降率 血液流变学 

分 类 号：R692[医药卫生—泌尿科学]