心脑血管病防治
心腦血管病防治
심뇌혈관병방치
Prevention and Treatment of Cardio-Cerebral-Vascular Disease
2015年
5期
366-368,374
,共4页
阿布都扎依尔买买提%木卡达斯迪力夏提%帕丽达阿布来提
阿佈都扎依爾買買提%木卡達斯迪力夏提%帕麗達阿佈來提
아포도찰의이매매제%목잡체사적력하제%파려체아포래제
血清胱抑素C%24h尿微量白蛋白%高血压%肾功能损害
血清胱抑素C%24h尿微量白蛋白%高血壓%腎功能損害
혈청광억소C%24h뇨미량백단백%고혈압%신공능손해
Cystatin C%24 h microalbuminuria%Hypertension%Renal impairment
目的：探讨血清胱抑素 C（Cys C）、24h 尿微量白蛋白（24h MAU）对高血压早期肾功能损害的诊断价值。方法收集高血压患者234例，用同位素肾图检查作为金标准测定肾小球滤过率（GFR），按照 GFR 数值分成三组：肾功能无损害组、肾功能受损代偿组、肾功能受损失代偿组，同时测定每组血清 Cys C 、24h MAU 、血肌酐及尿素氮，并分别计算每个指标在诊断高血压早期肾损害的灵敏度、特异度。结果随着 GFR 下降，血清 Cys C 、24h MAU 、血肌酐及尿素氮均值逐渐升高（P＜0.01）。将肾功能受损代偿组和肾功能受损失代偿组合并为肾功能受损组。肾功能无损害组79例患者血清中 Cys C 浓度异常者占3.80％，24h MAU 浓度异常者占11.40％，血肌酐浓度异常者占0.00％，尿素氮异常者占0.00％；肾功能受损组155例患者血清中 Cys C 浓度异常者占45.16％，24h MAU 浓度异常者占42.58％，血肌酐浓度异常者占18.06％，尿素氮异常者占18.71％。差异均有统计学意义（P＜0.01）。四项指标诊断高血压早期肾功能损害的灵敏度分别为45.20％、42.60％、18.10％、18.70％，特异度分别为96.20％、88.60％、100.00％、100.00％，四项指标诊断高血压早期肾功能损害的 ROC 曲线下面积分别为0.76、0.66、0.63、0.69。结论血清 Cys C 、24h MAU 是敏感且特异的反映肾小球滤过功能的指标，尤其是 Cys C 对高血压早期肾功能损害具有较高的诊断价值。
目的：探討血清胱抑素 C（Cys C）、24h 尿微量白蛋白（24h MAU）對高血壓早期腎功能損害的診斷價值。方法收集高血壓患者234例，用同位素腎圖檢查作為金標準測定腎小毬濾過率（GFR），按照 GFR 數值分成三組：腎功能無損害組、腎功能受損代償組、腎功能受損失代償組，同時測定每組血清 Cys C 、24h MAU 、血肌酐及尿素氮，併分彆計算每箇指標在診斷高血壓早期腎損害的靈敏度、特異度。結果隨著 GFR 下降，血清 Cys C 、24h MAU 、血肌酐及尿素氮均值逐漸升高（P＜0.01）。將腎功能受損代償組和腎功能受損失代償組閤併為腎功能受損組。腎功能無損害組79例患者血清中 Cys C 濃度異常者佔3.80％，24h MAU 濃度異常者佔11.40％，血肌酐濃度異常者佔0.00％，尿素氮異常者佔0.00％；腎功能受損組155例患者血清中 Cys C 濃度異常者佔45.16％，24h MAU 濃度異常者佔42.58％，血肌酐濃度異常者佔18.06％，尿素氮異常者佔18.71％。差異均有統計學意義（P＜0.01）。四項指標診斷高血壓早期腎功能損害的靈敏度分彆為45.20％、42.60％、18.10％、18.70％，特異度分彆為96.20％、88.60％、100.00％、100.00％，四項指標診斷高血壓早期腎功能損害的 ROC 麯線下麵積分彆為0.76、0.66、0.63、0.69。結論血清 Cys C 、24h MAU 是敏感且特異的反映腎小毬濾過功能的指標，尤其是 Cys C 對高血壓早期腎功能損害具有較高的診斷價值。
목적：탐토혈청광억소 C（Cys C）、24h 뇨미량백단백（24h MAU）대고혈압조기신공능손해적진단개치。방법수집고혈압환자234례，용동위소신도검사작위금표준측정신소구려과솔（GFR），안조 GFR 수치분성삼조：신공능무손해조、신공능수손대상조、신공능수손실대상조，동시측정매조혈청 Cys C 、24h MAU 、혈기항급뇨소담，병분별계산매개지표재진단고혈압조기신손해적령민도、특이도。결과수착 GFR 하강，혈청 Cys C 、24h MAU 、혈기항급뇨소담균치축점승고（P＜0.01）。장신공능수손대상조화신공능수손실대상조합병위신공능수손조。신공능무손해조79례환자혈청중 Cys C 농도이상자점3.80％，24h MAU 농도이상자점11.40％，혈기항농도이상자점0.00％，뇨소담이상자점0.00％；신공능수손조155례환자혈청중 Cys C 농도이상자점45.16％，24h MAU 농도이상자점42.58％，혈기항농도이상자점18.06％，뇨소담이상자점18.71％。차이균유통계학의의（P＜0.01）。사항지표진단고혈압조기신공능손해적령민도분별위45.20％、42.60％、18.10％、18.70％，특이도분별위96.20％、88.60％、100.00％、100.00％，사항지표진단고혈압조기신공능손해적 ROC 곡선하면적분별위0.76、0.66、0.63、0.69。결론혈청 Cys C 、24h MAU 시민감차특이적반영신소구려과공능적지표，우기시 Cys C 대고혈압조기신공능손해구유교고적진단개치。
Objective To evaluate the clinical significance of serum Cystatin C (Cys C) and 24h microalbuminuria (24h MAU) in diagnosis of early renal impaired patients with hypertension .Methods The study was performed on 234 hypertension patients .Check-ing for isotopes renal figure was used as the gold standard to measure the kidney estimated glomerular filtration rate (GFR) ,classify-ing the patients into three groups according to GFR numerical ,isotope simultaneous determination of serum Cys C ,24h MAU ,creati-nine (Scr) and blood urea nitrogen (BUN) of each group ,and calculating the sensitivity ,specific degrees of each index in the diag-nosis of early renal impairment in patients with hypertension ,making a comparison to evaluate the value of serum Cys C ,24h MAU in hypertension patients in early renal damage diagnosis .Results The mean levels of Cys C ,24h MAU ,Scr and BUN increased with the decrease of GFR (P< 0 .01) .Combining the second and third group as a renal damage group ,and the first group as nondestructive group for renal function .The ratio of patients with abnormal Cys C ,24h MAU ,Scr and BUN were 3 .8% ,11 .4% ,0 .0% and 0.0% in the first group (n = 79) ,45 .16% ,42 .58% ,18 .06% and 18 .71% in the renal damage group (n = 155) ,respectively . The sensitivity of four indexes of diagnosing patients with primary hypertension and early renal impairment were 45 .2% ,42 .6% , 18 .1% and 18 .7% ,the specificity were 96 .2% ,88 .6% ,100% and 100% .Area of ROC curves of four indexes of diagnosing patients with primary hypertension and early renal impairment were 0 .759 ,0 .655 ,0 .630 and 0 .689 .Conclusions Serum Cys C , 24h MAU are sensitive and specific marks of renal injury .They are more significant than the other two indexes for renal impairment in patients with hypertension ,of which the serum Cys C inhibition diagnosis is more worth than 24h MAU .
