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目的探讨血清胱抑素C(Cys-C)及尿微量白蛋白(mALB)、β2-微球蛋白(β2-M)、N-乙酰β-D-氨基葡萄糖苷酶(NAG)联合检测对高血压肾病早期损伤的诊断价值。方法根据WHO/ISH标准,将高血压患者分为高血压Ⅰ期(Ⅰ组:血压140～159/90～99mmHg);高血压期Ⅱ期(Ⅱ组:血压≥160/100mmHg);根据尿常规检查将高血压患者分为A组(无蛋白尿)和B组(有蛋白尿)。分别测定126例高血压患者和120例对照组人群尿液中mALB、β2-M、NAG及血清中Cys-C、BUN、Cr含量并进行比较,分析各组人群中mALB、β2-M、NAG、Cys-C、BUN、Cr异常检出率。结果Ⅰ组、Ⅱ组患者和对照组比较,mALB、β2-M、NAG、Cys-C含量差异有统计学意义(t分别为15.59,12.32和6.93,8.69,P值均<0.05),BUN、Cr差异无统计学意义(P值均>0.05);A、B组患者和对照组比较,mALB、β2-M、NAG、Cys-C含量差异有统计学意义(t分别为17.59,15.31和4.93,5.92,P均<0.05),BUN、Cr差异无统计学意义(P值均>0.05);高血压患者各组人群mALB、β2-M、NAG、Cys-C异常检出率差异有统计学意义(P<0.01),BUN、Cr异常检出率差异无统计学意义(P>0.05)。结论 Cys-C及尿肾功三项联合检测是高血压病肾脏损伤早期诊断灵敏、可靠的实验室指标。
Objective To investigate the relationship between serum cystatin C (Cys-C), urinary microalbumin (mALB), β2-microglobulin (β2-M) and N-acetyl-D-glucosaminidase Diagnostic value of early injury of blood pressure nephropathy. Methods According to WHO / ISH criteria, patients with hypertension were divided into two groups: stage Ⅰ (group Ⅰ: 140 ~ 159/90 ~ 99mmHg); stage Ⅱ (stage Ⅱ: group Ⅱ: blood pressure ≥160 / 100mmHg) Hypertension patients were divided into group A (proteinuria) and group B (proteinuria). The levels of mALB, β2-M, NAG and the levels of Cys-C, BUN and Cr in urine of 126 hypertensive patients and 120 controls were measured and compared. The levels of mALB, β2-M, NAG , Cys-C, BUN, Cr anomaly detection rate. Results Compared with the control group, the levels of mALB, β2-M, NAG and Cys-C in group Ⅰ and group Ⅱ were significantly different (t = 15.59,12.32 and 6.93,8.69 respectively, P < (P> 0.05). There was significant difference in the contents of mALB, β2-M, NAG and Cys-C between group A and B and control group (t = 17.59, 15.31 and 4.93 respectively , 5.92, P <0.05). There was no significant difference between BUN and Cr (P> 0.05). There was statistical difference in the detection rate of mALB, β2-M, NAG and Cys- (P <0.01). There was no significant difference in the detection rate of BUN and Cr (P> 0.05). Conclusion Cys-C and urinary and renal joint triad detection is a sensitive and reliable laboratory index for early diagnosis of renal damage in hypertensive patients.