慢性肾脏病患者血清超敏C反应蛋白水平变化

目的 观察慢性肾脏病(CKD)患者血清超敏C反应蛋白(hs-CRP)及胱抑素C(CysC)水平变化,分析hs-CRP对CKD的诊断价值.方法 从2016年6～11月到武汉大学人民医院就诊的患者中纳入CKD患者128例作为CKD组,以101例同期体检健康者作为对照(对照组).分别检测两组受检者的血肌酐(SCr)、hsCRP和Cys C,并计算肾小球滤过率(GFR).独立样本t检验比较CKD组和对照组SCr、hs-CRP、CysC水平的差异;绘制ROC曲线,评价SCr、hs-CRP、CysC对CKD的诊断价值;并通过Pearson相关检验分析CKD患者hs-CRP与GFR的相关性.结果 CKD组患者SCr(476±273.5)μmol/L]、hs-CRP(14.54±26.43)]mg/L和CysC(4.13±2.05)mg/L]水平均高于对照组(60.9±14.5)μmol/L、(0.58±0.69)mg/L、(1.06±0.28)mg/L],差异均有统计学意义(P<0.05);CKD患者hs-CRP与GFR水平呈负相关(r=-0.356,P<0.01);SCr、hs-CRP、CysC三指标诊断CKD的ROC曲线下面积分别为0.997、0.846、0.970.结论 CKD患者超敏C反应蛋白含量明显增加,且与肾损伤程度呈正相关,对诊断慢性肾脏病有一定的辅助价值,可用来评估病情的严重程度.

Change of serum high-sensitivity C-reactive protein in patients with chronic kidney disease

Objective To study the change of serum high-sensitivity C-reactive protein (hs-CRP) and cystatin C (CysC) in patients with chronic kidney disease (CKD), and to analyze the diagnostic value of hs-CRP in the treatment of CKD. Methods A total of 128 CKD patients, who admitted to Renmin Hospital of Wuhan University from Jun. 2016 to Nov. 2016, were selected the CKD group. During the same period, 101 patients of routine physical examination in our hospital were enrolled as the control group. The serum creatinine concentration (SCr), hs-CRP and CysC of the two groups were detected and the glomerular filtration rate (GFR) was calculated. The differences between the CKD group and the control group in three indicators were compared by independent-samples t-test. The diagnostic value of three indicators was evaluated via ROC curve. Pearson correlation test was used to analyze the relationship between hs-CRP and GFR. Results The levels of SCr, hs-CRP, and CysC in CKD patients were (476 ± 273.5)μmol/L, (14.54 ± 26.43) mg/L, (4.13 ± 2.05) mg/L, respectively, which were significantly higher than corresponding (60.9 ± 14.5)μmol/L, (0.58 ± 0.69) mg/L, (1.06 ± 0.28) mg/L in the control group (P<0.05). With the decline of GFR, the level of hs-CRP in-creased gradually and the negative correlation was demonstrated between them (r=-0.356, P<0.01). The areas under the ROC curve of SCr, hs-CRP and CysC for CKD were 0.997, 0.846, 0.970, respectively. Conclusion The concentration of hs-CRP in patients with CKD increases significantly and shows the positive correlation with the degree of injury in re-nal function. hs-CRP has a certain value in the diagnosis of chronic kidney disease, which can be used to assess the sever-ity of the disease.