尿白蛋白与肌酐比值联合血肌酐对老年高血压患者早期肾小球滤过率下降的诊断价值  

Diagnostic value of urea albumin creatinine ratio combined with serum creatinine to early decrease of glomerular filtration rate in elderly patients with hypertension

作　　者：陈睿[1] 王旁[1] 彭燕 孙世仁[1] 张婧 Chen Rui;Wang Pang;Peng Yan;Sun Shiren;Zhang Jing(Department of Preventive Medicine,Xijing Hospital,Fourth Military Medical University,Xi'an 710032,China;不详)

机构地区：[1]第四军医大学西京医院预防保健科,西安710032 [2]空军军医大学第一附属医院预防保健科,西安710032

出　　处：《中国循证心血管医学杂志》2021年第3期325-328,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：陕西省科技厅资助项目(2015SF161)。

摘　　要：目的分析尿白蛋白与肌酐的比值(UACR)联合血肌酐(SCr)对老年高血压患者早期肾小球滤过率(GFR)下降的诊断价值。方法选取2017年3月至2018年12月于第四军医大学西京医院收治的老年高血压患者260例作为高血压组,根据血压水平将其分为高血压1级组、高血压2级组和高血压3级组,根据GFR将其分为肾功能正常组和肾功能受损组。另选取100例于第四军医大学西京医院体检的健康老年人作为对照组。比较高血压组和对照组、各个亚组的收缩压、舒张压、SCr、UACR、GFR水平,采用受试者操作特征曲线(ROC)分析UACR联合SCr对老年高血压患者早期GFR下降的诊断价值。结果高血压组患者的收缩压、舒张压、SCr、UACR均明显高于对照组,GFR明显低于对照组(P<0.05),高血压3级组患者的收缩压、舒张压、SCr、UACR均明显高于高血压2级组和高血压1级组,GFR明显低于高血压2级组和高血压1级组(P<0.05),高血压2级组的收缩压、舒张压、SCr、UACR均明显高于高血压1级组,GFR明显低于高血压1级组(P<0.05),肾功能受损组的收缩压、舒张压、SCr、UACR均明显高于肾功能正常组,GFR明显低于肾功能正常组(P<0.05),SCr联合UACR检测有较高的诊断价值,曲线下面积为0.949,敏感度为85.15%,特异性为94.25%。结论SCr联合UACR对老年高血压患者早期GFR下降有较高的诊断价值。Objective To analyze the diagnostic value of urea albumin creatinine ratio(UACR)combined with serum creatinine(SCr)to early decrease of glomerular filtration rate(GFR)in elderly patients with hypertension(HTN).Methods The elderly patients with HTN(n=260)were chosen into HTN group from Xijing Hospital of the Fourth Military Medical University from Mar.2017 to Dec.2018,and it was further divided,according to blood pressure level,into HTN grade 1 subgroup,HTN grade 2 subgroup and HTN grade 3 subgroup.And again it was divided,according to GFR level,into renal normal subgroup and renal impaired subgroup.The healthy elderly people(n=100)were chosen into control group who had physical examinations in Xijing Hospital of the Fourth Military Medical University.The levels of systolic blood pressure(SBP),diastolic blood pressure(DBP),SCr,UACR and GFR were compared in HTN group,control group and all subgroups.The diagnostic value of UACR combined with SCr to early GFR decrease was analyzed by using receiver operating characteristic(ROC)curve.Results The levels of SBP,DBP,SCr and UACR were significantly higher,and GFR level was significantly lower in HTN group than those in control group(P<0.05).The levels of SBP,DBP,SCr and UACR were significantly higher,and GFR level was significantly lower in HTN grade 3 subgroup than those in HTN 1 and 2 subgroups(P<0.05).The levels of SBP,DBP,SCr and UACR were significantly higher,and GFR level was significantly lower in HTN grade 2 subgroup than those in HTN 1 subgroups(P<0.05).The levels of SBP,DBP,SCr and UACR were significantly higher,and GFR level was significantly lower in renal impaired subgroup than those in renal normal subgroup(P<0.05).SCr combined with UACR had higher diagnostic value,and area under ROC curve was 0.949,sensitivity was 85.15%and specificity was 94.25%.Conclusion SCr combined with UACR had higher diagnostic value to early GFR decrease in elderly patients with HTN.

关 键 词：高血压 肾损害 尿白蛋白与肌酐比值 血肌酐 诊断价值 

分 类 号：R542.22[医药卫生—心血管疾病]