血清同型半胱氨酸与胱抑素C联合检测对ANCA相关性肾损伤的诊断价值  

Diagnostic value of homocysteine combined with C cystatin inANCA-associated renal injury

作　　者：王婵 谈方方 方珊 张彦青 段新旦 樊星涛 王欣 WANG Chan;TAN Fangfang;FANG Shan;ZHANG Yanqing;DUAN Xindan;FAN Xingtao;WANG Xin(Nuclear Industry 215 Hospital,Xianyang 712000,China)

机构地区：[1]核工业二一五医院,陕西咸阳712000

出　　处：《西安交通大学学报（医学版）》2024年第4期616-620,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：核工业二一五医院院级科研项目(No.2016-2)。

摘　　要：目的 研究抗中性粒细胞胞浆抗体(antineutrophil cytoplasmic antibody, ANCA)相关性血管炎(ANCA-associated vasculitis, AAV)相关性肾损伤患者血清中同型半胱氨酸(HCY)与胱抑素C(Cys-C)的水平,探讨血清HCY和Cys-C联合检测对ANCA相关性肾损伤的诊断价值。方法 选取本院2016年1月—2019年1月肾内科收治的70例ANCA阳性合并肾损伤的患者,另选择同期前来就诊的48例ANCA阳性但并未合并肾损伤的患者(单纯ANCA阳性组)和50例体检的健康者(对照组)。比较各组检测结果并确定各检测指标对ANCA阳性合并肾损伤的受试者工作特征(ROC)曲线的曲线下面积(AUC),计算HCY、Cys-C联合检测对ANCA相关性肾损伤的相关性及诊断价值。结果 ANCA阳性合并肾损伤组、单纯ANCA阳性组与对照组中血清HCY、Cys-C水平差异有统计学意义(P<0.05);各组HCY、Cys-C的阳性率差异有统计学意义(P<0.05)。HCY、Cys-C联合诊断对ANCA阳性相关性肾损伤的诊断灵敏度、特异度高于上述指标单独检测,差异有统计学意义(P<0.05);ROC曲线结果显示,HCY联合Cys-C对ANCA阳性合并相关性肾损伤的患者具有较好的诊断价值和较高的相关性。结论 HCY与Cys-C联合检测与AAV相关性肾损伤密切相关,联合检测对ANCA阳性相关性肾损伤患者的诊断有积极作用,对患者治疗具有指导价值。Objective To investigate the serum levels of homocysteine(HCY)and cystatin C(Cys-C)in patients with antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV)associated renal injury,and to explore the diagnostic value of combined detection of HCY and Cys-C in ANCA-associated renal injury.Methods We selected 70 ANCA-positive patients with renal injury admitted to the Department of Nephrology in our hospital from January 2016 to January 2019.Another 48 patients with ANCA-positive but not complicated with renal injury were in simple ANCA positive group while 50 patients with physical examination who came to the hospital during the same period were in control group.Healthy patients served as the control group.By comparing the differences in the test results of different groups,the area under the curve(AUC)of each test index for ANCA-positive renal injury was determined,and the correlation and diagnostic value of combined detection of HCY and Cys-C for ANCA-related renal injury were calculated.Results The levels of HCY and Cys-C in the ANCA positive combined with renal injury group,the pure ANCA positive group,and the control group differed significantly(P<0.05).The positive rates of HCY and Cys-C in the two groups were significantly different(P<0.05).The sensitivity and specificity of HCY and Cys-C in combination for the diagnosis of ANCA-positive related renal injury were significantly higher than those of the above indicators alone(P<0.05).ROC curve results showed that HCY combined with Cys-C had a better diagnosis for patients with positive ANCA and associated renal injury and a higher correlation.Conclusion HCY combined with Cys-C is closely correlated to ANCA-related renal injury,and the combined detection has a positive effect on the diagnosis of patients with ANCA-positive related renal injury,and has guiding value for the treatment of patients.

关 键 词：抗中性粒细胞胞浆抗体(ANCA) ANCA相关性血管炎(AAV) 肾损伤 血清同型半胱氨酸(HCY) 胱抑素C(Cys-C) 

分 类 号：R587.2[医药卫生—内分泌]