高血压患者早期肾损害多指标联合检测的意义

目的：探讨联合应用血清胱抑素-C （Cys-C）、视黄醇结合蛋白（RBP）、超敏 C-反应蛋白（hsCRP）、尿微量白蛋白（UMA）对原发性高血压患者早期肾功能损害检测的临床意义。方法：分别测定83例原发性高血压患者（高血压组）及年龄相当的80例健康体检者（健康对照组）的Cys-C、RBP、UMA水平，并计算其单独和联合测定的阳性率（超过正常值上限）。结果：与健康对照组比较，高血压组患者 Cys-C （0.98±0.30）μg/ml 比（1.23±1.38）μg/ml]、RBP （38.32±10.10）mg/L比（41.67±11.68）mg/L]、UMA （1.17±0.46）mg/L比（3.01±3.31）mg/L]水平均明显升高（P＜0.05或＜0.01），对早期肾损害的检出率（阳性率）分别是21.69％、19.28％、14.46％、19.28％。两指标联用后的检出率分别为Cys-C＋UMA：36.14％， UMA＋RBP：34.94％，较单指标的检出率有显著性提高（P均＜0.05）。结论：适当选择多指标联合检测可有效提高高血压患者早期肾功能损害的检出率。

Clinical significance of combined detecting multiple indexes for early renal damage in patients with hy-pertension

Objective：To explore the clinical significance of combined detecting serum cystatin C （Cys-C）,retinol binding protein （RBP）,high sensitive C reactive protein （hsCRP）and urine microalbuminuria （UMA）for early re-nal damage detection in patients With essential hypertension （EH）.Methods：Levels of Cys-C,RBP and UMA Were measured in 83 EH patients （EH group）and 80 healthy objects With similar age （healthy control group）respective-ly.Positive rates （exceeding upper limit of normal value for above index Was regarded as positive） of single and combined use of above indexes Were calculated.Results：Compared With healthy control group,there Were signifi-cant increase in levels of Cys-C （0.98±0.30）μg/ml vs.（1.23±1.38）μg/ml],RBP （38.32±10.10）mg/L vs. （41.67±11.68）mg/L],and UMA （1.17±0.46）mg/L vs.（3.01±3.31）mg/L]in EH group （P〈0.05 or 〈0.01）,and their detection rates for early renal damage Were 21.69%,19.28%,14.46% and 19.28% respectively. Combined detecting rates of Cys-C ＋ UMA and UMA＋ RBP Were 36.14% and 34.94% respectively,Which Were significantly higher than those of single index （P〈0.05 all）.Conclusion：Proper multi-index combined detecting can effectively raise the detection rate of early renal damage in patients With hypertension.