尿微量清蛋白及血清学指标与高血压合并动脉粥样硬化性肾动脉狭窄的关系研究  

Relationship between urinary microalbumin,serological indicators and hypertension complicated with atherosclerotic renal artery stenosis

作　　者：袁洪伟 刘继轩 周力[1] 陈晖[1] YUAN Hongwei;LIU Jixuan;ZHOU Li;CHEN Hui(Department of Vascular Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100032,China)

机构地区：[1]首都医科大学附属北京友谊医院血管内科,北京100032

出　　处：《检验医学与临床》2024年第21期3147-3151,3156,共6页Laboratory Medicine and Clinic

基　　金：首都卫生发展科研专项基金(首发2022-4028-086)。

摘　　要：目的探讨尿微量清蛋白(MAU)及血清学指标与高血压合并动脉粥样硬化性肾动脉狭窄的关系。方法选择2021年1月至2022年1月于该院治疗的220例高血压合并动脉粥样硬化性肾动脉狭窄患者为观察组,110例高血压合并动脉粥样硬化性肾动脉非狭窄患者为对照组。根据肾动脉狭窄严重程度将观察组分为严重组、轻度组2个亚组。比较各组患者MAU及血清学指标之间的差异;采用Logistic回归分析动脉粥样硬化性肾动脉狭窄严重程度的影响因素;绘制受试者工作特征(ROC)曲线,分析多指标联合应用预测患者动脉粥样硬化性肾动脉狭窄严重程度的价值。结果观察组尿微量清蛋白(MAU)、血清肌酐(Scr)、尿素氮(BUN)、糖化血红蛋白(HbA1c)、尿酸(UA)、同型半胱氨酸(Hcy)、脂蛋白a[Lp(a)]、血管紧张素Ⅱ(AⅡ)水平均明显高于对照组(P<0.05)。严重组MAU、Scr、BUN、HbA1c、UA、Hcy、Lp(a)、AⅡ水平均明显高于轻度组(P<0.05)。Logistic回归分析显示,MAU、Scr、BUN、UA、Hcy、Lp(a)、AⅡ均是动脉粥样硬化性肾动脉狭窄严重程度的影响因素(P<0.05)。MAU、Scr、BUN、UA、Hcy、Lp(a)、AⅡ单独及联合预测患者动脉粥样硬化性肾动脉狭窄严重程度的曲线下面积分别为0.787(0.656~0.923)、0.840(0.680~0.973)、0.773(0.604~0.929)、0.757(0.574~0.936)、0.805(0.604~0.984)、0.862(0.751~0.966)、0.762(0.588~0.941)、0.955(0.934~0.969),其中联合应用预测效能更高。结论MAU及血清学指标与动脉粥样硬化性肾动脉狭窄有关,可作为疾病早期筛查的重要指标。Objective To investigate the relationship between microalbuminuria(MAU),serological indexes and hypertension complicated with atherosclerotic renal artery stenosis.Methods A total of 220 patients diagnosed with hypertension combined with atherosclerotic renal artery stenosis,who received treatment in the hospital from January 2021 to January 2022,were selected as the observation group.Additionally,110 patients with hypertension but without atherosclerotic renal artery stenosis were selected as the control group.The observation group was further divided into two subgroups based on the severity of renal artery stenosis including the severe group and the mild group.The differences in MAU and serological indexes between the groups were compared.Logistic regression analysis was used to identify the influencing factors of the severity of atherosclerotic renal artery stenosis.Receiver operating characteristic(ROC)curve was drawn to assess the value of using multiple combined indicators to predict the severity of atherosclerotic renal artery stenosis in patients.Results The levels of urinary microalbumin(MAU),serum creatinine(Scr),blood urea nitrogen(BUN),glycosylated hemoglobin(HbA1c),uric acid(UA),homocysteine(Hcy),lipoprotein(a)[Lp(a)]and angiotensinⅡ(AⅡ)in the observation group were significantly higher than those in the control group(P<0.05).Additionally,the levels of MAU,Scr,BUN,HbA1c,UA,Hcy,Lp(a)and AⅡin the severe group were significantly higher than those in the mild group(P<0.05).Logistic regression analysis showed that MAU,Scr,BUN,UA,Hcy,Lp(a)and AⅡwere all significant factors influencing the severity of atherosclerotic renal artery stenosis(P<0.05).The area under the curve(AUC)for the prediction of the severity of atherosclerotic renal artery stenosis based on MAU,Scr,BUN,UA,Hcy,Lp(a)and AⅡindividually and in combination were 0.787(0.656-0.923),0.840(0.680-0.973),0.773(0.604-0.929),0.757(0.574-0.936),0.805(0.604-0.984),0.862(0.751-0.966),0.762(0.588-0.941) and 0.955(0.934-0.969)respectively,with com

关 键 词：尿微量清蛋白 糖化血红蛋白 脂蛋白A 血管紧张素Ⅱ 动脉粥样硬化性肾动脉狭窄 诊断价值 

分 类 号：R692.16[医药卫生—泌尿科学] R544.1[医药卫生—外科学]