肾功能指标联合分析对老年高血压病早期肾损害的诊断价值

目的观察老年高血压病患者尿素（Urea）、肌酐（Cr）、尿酸（UA）、β2-微球蛋白（β2-MG）和胱抑素C（Cysc）5项肾功能指标对检出早期肾损害的价值。方法使用全自动生化分析仪对152例老年高血压病患者和50例正常人血清中5项肾功能指标进行检测，并对检测结果进行统计学分析。结果尿蛋白阴性的老年高血压病组血Urea和Cr浓度与健康对照组比较差异无统计学意义，而UA、β2-MG和Cys C浓度与健康对照组比较差异有统计学意义（P〈0．01），其曲线下面积分别为0．727、0．907、0．817，在各最佳截断点的灵敏度分别为52．7％、78、2％、72、7％，特异度分别为98．4％、94．7％、78．9％。在诊断老年高血压病患者早期肾损害中联合检测较单项指标阳性率高，以联合检测UA、β2-MG和Cys C这3项肾功能指标组阳性率最高，达86．8％。结论检测血UA、β2-MG和Cys C是诊断老年高血压病早期肾损害的敏感指标，联合检测有较高的检出率，对高血压性肾病的早期诊断有重要意义，适合在临床推广使用。

Diagnostic value of the combined detection of renal function markers for early renal damage in old patients with primary hypertension

Objective To investigate the value of the combined detection of five renal function biochemical indicators including urea nitrogen (Urea), creatinine (Crea), uric acid (UA),β2-microglobulin (β2-MG), cystatin C (Cys C) for the diagnosis of early renal damage in old patients with primary hypertension.Methods The five serum biochemical indicators were detected by automatic biochemical analyzer in 152 old patients with primary hypertension(hypertension group) and 50 healthy controls (healthy control group), and the results were statistically analyzed.Results There was not significant differences of serum levels of Urea and Cr between hypertension group (with urine protein negative) and healthy control group (P>0.05), but the differences of UA,β2-MG and Cys C were statistically significant. In hypertension group, the AUCs of UA,β2-MG and Cys C were 0.727,0.907 and 0.817 respectively, while at optimal cutoff point, sensitivities were 52.7%, 78.2% and 72.7%, specificities were 98.4%, 94.7% and 78.9% respectively.The positive rate of combined detection were higher than that of single test, especially for three indices (UA,β2-MG and Cys C) combined detection, the positive rate accounted for 86.8%.Conclusion UA,β2-MG and Cys C are sensitive markers of early renal damage in old patients with primary hypertension, and the detection rate of combined detection is higher, contributing to the early diagnosis of hypertensive nephropathy suitable to spread in clinic.