高血压肾病早期血清Cys C、β_(2)-MG和尿NAG、RBP水平检测及临床意义  

Detection and clinical significance of serum Cys C,urinary β_(2)-microglobulin,N-acetyl-β-D-aminoglucosidase,and retinol binding protein levels in early stage of hypertensive nephropathy

作　　者：张志斌 温庆辉[1] 张锡波 ZHANG Zhi-bin;WEN Qing-hui;ZHANG Xi-bo(Dongguan People’s Hospital,Dongguan 523000,Guangdong,CHINA)

机构地区：[1]东莞市人民医院检验科,广东东莞523000

出　　处：《海南医学》2021年第23期3024-3027,共4页Hainan Medical Journal

摘　　要：目的检测高血压肾病患者早期血清胱抑素C (CysC)、尿β_(2)-微球蛋白(β_(2)-MG)和尿N-乙酰-β-D-氨基葡萄糖苷酶(尿NAG)、尿视黄醇结合蛋白(RBP)水平,并探讨其临床意义。方法选择2019年11月至2020年10月东莞市人民医院收治的70例高血压患者为研究对象,其中高血压肾病40例(HRD组),单纯高血压30例(HBP组);选择同期在我院体检的健康者30例作为对照组。HRD组根据慢性肾病分期分为Ⅰ~Ⅱ期23例,Ⅲ~Ⅴ期17例。检测并比较各组受检者的CysC、β_(2)-MG、尿NAG和RBP水平,比较上述指标单独与联合检测诊断高血压肾病的灵敏度、特异性,采用Pearson法分析4项指标之间的相关性。结果 HRD组患者的Cys C、β_(2)-MG、尿NAG、RBP水平明显高于HBP组和对照组,而HBP组上述指标明显高于对照组,差异均有统计学意义(P<0.05);Ⅲ~Ⅴ期患者的Cys C、β_(2)-MG、尿NAG、RBP水平分别为(28.87±5.09) mg/L、(5.91±1.43) mg/L、(29.12±4.18) U/L、(5.89±1.31) mg/L,明显高于Ⅰ~Ⅱ期患者的(17.98±3.11) mg/L、(3.89±0.98) mg/L、(20.17±3.98) U/L、(3.79±1.09) mg/L,差异均有统计学意义(P<0.05);高血压肾病患者血清CysC检测敏感度为58.82%、特异度为50.00%;β_(2)-MG的敏感度为64.71%、特异度为50.00%;尿NAG敏感度为70.59%,特异度为66.67%;RBP敏感度为79.41%,特异度为66.67%,均分别低于4项指标联合检测的敏感度96.77%、特异性83.33%,差异均有统计学意义(P<0.05);高血压肾病患者血清CysC与尿NAG、RBP表达水平呈正相关(r=0.981、0.671,P<0.05),而β_(2)-MG与尿NAG、RBP也呈正相关(r=0.617、0.751,P<0.05)。结论高血压肾病患者的血清CysC、β_(2)-MG、尿NAG、RBP水平明显高于健康体检者,与病情严重程度呈正相关,四项指标联合检测更有利于高血压肾早期损伤的临床诊断。Objective To detect the levels of serum cystatin C(CysC),and urine β_(2)-microglobulin(β_(2)-MG),and urinary N-acetyl-β-D-aminoglucosidase(urinary NAG),and urinary retinol binding protein(RBP) in patients with hypertensive nephropathy,and to explore their clinical significance.Methods Seventy patients with hypertension treated in Dongguan People’s Hospital from November 2019 to October 2020 were selected as the research objects,including40 patients of hypertensive nephropathy(HRD group) and 30 patients of simple hypertension(HBP group).Thirty healthy persons who underwent physical examination in Dongguan People’s Hospital during the same period were selected as the control group.HRD group was divided into 23 patients of stage Ⅰ~Ⅱ and 17 patients of stage Ⅲ~Ⅴ according to the stage of chronic kidney disease.CysC,β_(2)-MG,urinary NAG,and RBP were compared.The sensitivity and specificity of single detection and combined detection of the above indexes in the diagnosis of hypertensive nephropathy were compared.The correlation between the four indexes was analyzed by Pearson method.Results Cys C,β_(2)-MG,urinary NAG,and RBP in HBP group were significantly higher than those in HBP group and control group,while the above indexes in HBP group were significantly higher than those in control group(P<0.05).The levels of CysC,β_(2)-MG,urinary NAG,and RBP of patients with stage Ⅲ ~ Ⅴ were(28.87 ± 5.09) mg/L,(5.91 ± 1.43) mg/L,(29.12 ± 4.18) U/L,(5.89±1.31) mg/L,which were significantly higher than(17.98±3.11) mg/L,(3.89±0.98) mg/L,(20.17±3.98) U/L,(3.79±1.09) mg/L of stage Ⅰ~Ⅱ patients(P<0.05).The sensitivity and the specificity of serum CysC in patients with hypertensive nephropathy were 58.82% and 50.00%;64.71% and 50.00% of β_(2)-MG;70.59% and 66.67% of urine NAG;79.41%and 66.67% of RBP,which were significantly lower than 96.77% and 83.33% of the combined detection of the four indicators(P<0.05).Serum CysC in patients with hypertensive nephropathy was positively correlated with urinary NAG

关 键 词：高血压肾病 血清胱抑素C 尿β_(2)-微球蛋白 尿N-乙酰-Β-D-氨基葡萄糖苷酶 尿视黄醇结合蛋白 

分 类 号：R544.14[医药卫生—心血管疾病]