血清Cys-C、β2MG、SCr诊断慢性肾衰竭并发心力衰竭的价值及与心功能分级的关系  

The value of serum Cys-C,β2MG and SCr in the diagnosis of chronic renal failure complicated with heart failure and their relationship with cardiac function grading

作　　者：尚传波 陈欣 陈建国 SHANG Chuanbo;CHEN Xin;CHEN Jianguo(Department of Nephrology,Wuhu First People's Hospital,Wuhu,Anhui 241000,China;不详)

机构地区：[1]芜湖市第一人民医院肾内科,安徽芜湖241000 [2]合肥市第一人民医院老年医学科,安徽合肥230061

出　　处：《中华全科医学》2025年第3期425-429,共5页Chinese Journal of General Practice

基　　金：2020年安徽省自然科学基金项目(2008085MH257)。

摘　　要：目的分析慢性肾衰竭(CRF)并发心力衰竭的诊断中应用血清胱抑素C(Cys-C)、β2微球蛋白(β2MG)、肌酐(SCr)检测的价值,并分析其与患者心功能分级的关系,为临床诊断该疾病提供参考。方法本研究为前瞻性随机对照研究,选取芜湖市第一人民医院2020年1月-2023年7月收治的60例CRF并发心力衰竭患者作为观察组,选取同期60例CRF患者作为单纯CRF组,另选取同期60例健康体检者作为对照组。比较3组研究对象及观察组不同心功能分级患者血清Cys-C、β2MG、SCr水平。采用ROC曲线分析血清Cys-C、β2MG、SCr单独及联合检测诊断CRF并发心力衰竭的价值。采用logistic回归分析研究影响CRF并发心力衰竭患者心功能分级的因素。结果观察组血清Cys-C、β2MG、SCr水平高于单纯CRF组和对照组,单纯CRF组高于对照组(P<0.05);观察组心功能Ⅳ级患者血清Cys-C、β2MG、SCr水平均高于Ⅰ级、Ⅱ级、Ⅲ级患者(P<0.05)。血清Cys-C、β2MG、SCr联合检测诊断CRF并发心力衰竭的AUC值均高于单项检测(Z=4.303、3.843、5.867,均P<0.05)。Logistic回归分析结果显示,血清Cys-C、β2MG、SCr水平均为CRF并发心力衰竭患者心功能分级的影响因素(P<0.05)。结论血清Cys-C、β2MG、SCr均为CRF并发心力衰竭患者心功能分级的影响因素,三者联合检测对CRF并发心力衰竭的诊断价值更高。Objective To analyze the value of serum cystatin C(Cys-C),β2 microglobulin(β2MG)and creatinine(SCr)in the diagnosis of chronic renal failure(CRF)complicated with heart failure,and to analyze their relationship with cardiac function,so as to provide reference for clinical diagnosis of this disease.Methods A total of 60 patients with CRF complicated with heart failure admitted to Wuhu First People's Hospital from January 2020 to July 2023 were selected as the observation group,another 60 patients with CRF during the same period were selected as the simple CRF group,and 60 healthy subjects during the same period were selected as the control group.Serum levels of Cys-C,β2MG and SCr were compared between the three groups of subjects and those in the observation group with different cardiac function grades.The value of serum Cys-C,β2MG and SCr alone or combined in the diagnosis of CRF complicated with heart failure was analyzed by ROC curve,and the relationship between serum Cys-C,β2MG and SCr and cardiac function grades was analyzed.Results The serum levels of Cys-C,β2MG and SCr in observation group were higher than those in simple CRF group and control group,and those in simple CRF group were higher than those in control group(P<0.05).The levels of Cys-C,β2MG and SCr in gradeⅣpatients were higher than those in gradeⅠ,gradeⅡand gradeⅢpatients(P<0.05).The AUC value of serum Cys-C,β2MG and SCr combined detection in the diagnosis of CRF complicated with heart failure was higher than that of single detection(Z=4.303,3.843,5.867,all P<0.05).Logistic regression analysis showed that serum Cys-C,β2MG and SCr levels were the influencing factors of cardiac function classification in patients with CRF complicated with heart failure(P<0.05).Conclusion Serum Cys-C,β2MG and SCr are the influencing factors of cardiac function classification in patients with CRF complicated with heart failure,and the combined detection of CRF and heart failure has higher diagnostic value.

关 键 词：慢性肾衰竭 心力衰竭 心功能分级 胱抑素C Β2微球蛋白 

分 类 号：R692.5[医药卫生—泌尿科学] R541.6[医药卫生—外科学]