ROC曲线评价血清胱抑素C对原发性高血压早期轻度肾损害的诊断价值

目的 探讨ROC曲线评价血清胱抑素C(CysC)对原发性高血压早期轻度肾损害的诊断价值.方法 选取原发性高血压血肌酐(Cr)正常患者290例,检测血清CysC及尿微量白蛋白/尿肌酐比值(mAlb/Cr,ACR),尿ACR≥30 mg/g为病例组,ACR＜ 30 mg/g为对照组,运用ROC曲线评价血清CysC诊断高血压轻度肾损害的诊断价值.结果 血清CysC水平病例组与对照组比较差异有统计学意义(P＜0.05);CysC诊断高血压早期轻度肾损害的ROC曲线下面积为0.944,95％可信区间0.912 ～0.968.灵敏度92.00％,特异度89.36％,阳性预测值90.2％,阴性预测值91.3％.结论 血清CysC水平升高能反映原发性高血压患者早期轻度肾损害,血清CysC＞ 1.22 mg/L可作为诊断切点.

The value of ROC curve of serum cystatin C on the early renal function injury in patients with essential hypertension

Objective To investigate the diagnosis value of ROC curve on the serum cystatin C (CysC) of early renal function injury in patients with essential hypertension.Methods 290 cases of essential hypertension persons were divided into two groups by the results of urinary Albumin/Creatinine ratio(ACR).The diagnostic cut-off value was determined by ROC curve.Results When the cut-off value was 1.22,the ROC curve had the largest area under the curve(AUC) of 0.944,the sensitivity was 92％,specificity was 89.36％,the positive predictive value was 90.2％ and the negative predictive value was 91.3％.Conclusion The value of serum Cys C which is higher than 1.22 mg/1 can be used as important indicator for early diagnosis of kidney injury in patients with essential hypertension.