尿酸和血清胱抑素C对高血压肾损害早期诊断的预测价值

Prediction of Renal Damage Complicated by Hypertension With Uric Acid and Serum Cystatin C as Early Marker

摘要: 目的: 探讨血尿酸和血清胱抑素C对高血压肾损害的早期诊断价值。方法: 前瞻性纳入我院收治的原发性高血压患者151例。根据是否并发肾损害，将患者分为单纯高血压组(I组)和高血压肾损害组(Ⅱ组)，采用全自动生化分析仪同时测定血清尿酸、肌酐和尿素氮，免疫透射比浊法测定血清胱抑素C含量，并与健康体检者(对照组)相关指标作对比研究，并进行相关分析，评价血尿酸和血清胱抑素C对高血压肾损害早期诊断的价值。结果：I组、Ⅱ组血尿酸和血清胱抑素C的阳性率明显高于对照组(P < 0.01)。同组患者血尿酸和血清胱抑素C的阳性率明显高于其血尿素和血肌酐阳性率(P < 0.01)。此外，高血压患者血尿酸和血清胱抑素C的升高早于血尿素和血肌酐。结论: 血尿酸和血清胱抑素C是反映高血压早期肾功能损害的敏感指标，其敏感度高于血尿素和血肌酐，在诊断高血压早期肾损害方面有重要的临床价值。
>Abstract: Objective: To determine whether blood uric acid and serum cystatin C were early biomarkers of renal dam- age secondary to hypertension. Methods: A total of 151 eligible patients were enrolled in this prospective study. Ac- cording to the rate of kidney damage, the patients were divided into hypertension group (group I) and hyper-tensive renal injury group (groupⅡ). The concentrations of blood uric acid, creatinine and urea nitrogen were measured by automatic chemistry analysis and the concentration of serum cystatin C was measured by immune transmission nephelometry. The results were compared with those in control group and the evaluation was etrospectively analyzed. Results: The blood uric acid and serum cystatin C-positive rates of group I and groupⅡwere significantly higher than those of the control group (P < 0.01). However, the blood uric acid and serum cystatin C-positive rates in hypertensive patients were significantly higher than the blood urea and serum creatinine-positive rates (P < 0.01). In addition, the blood uric acid and serum cystatin C in hypertensive patients increased far earlier than blood urea and serum creatinine did. Conclusion: The blood uric acid and serum cystatin C are the sensitive indicators of hypertension with early renal damage. The sensitivity of blood uric acid and serum cystatin C is higher than that of the blood urea and serum creatinine. Therefore, detection of blood uric acid and serum cystatin C level has important clinical value in the diagnosis of hypertension with early renal damage.