尿微量白蛋白及血清胱抑素C联合检测对早期肾功能损伤临床探析.docVIP

尿微量白蛋白及血清胱抑素C联合检测对早期肾功能损伤临床探析 　 作者：杜立树, 平龙玉 涂林, 范文成, 冯霞 【摘要】 目的 探讨尿微量白蛋白、血清胱抑素C水平对高血压、糖尿病早期肾功能损害的临床诊断价值评价。方法 将研究对象分为高血压组、糖尿病组、阳性对照组及阴性对照组。取晨尿,免疫透射比浊法检测尿微量白蛋白;乳胶增强散射免疫比浊法检测血清胱抑素C;酶法检测血清肌酐和尿素氮。结果 高血压组及糖尿病组患者尿微量白蛋白,血清胱抑素C水平均显示高于正常对照组（Plt;0.01）,尿微量白蛋白和血清胱抑素C检出率显著高于阴性对照组。 结论 尿微量白蛋白和血清胱抑素C水平是肾功能损害的早期标志物;联合检测可提高糖尿病和高血压早期肾功能损害检出率。 【关键词】 尿微量白蛋白; 血清胱抑素C; 肾小球滤过率 【Abstract】 Objective To investigate the clinical value of UMA and SCysC levels in the patients with early renal function injury caused by hypertension and diabetes mellitus.Methods All the cases were individed in to four groups:DM group;Hp group ;degenerative nephrosis group and healthy control group.UMA was detected with the immune transmission nephelometry.SCysC was detected with grains strengthen immunoturbidimetry.Cr and BUN levels in serum were detected with enzymic method.Results UMA and SCysC levels in hypertension and diabeticpatient were significantly higher than normal control （Plt;0.01）.The abnormal rates for UMA and SCysC were significantly higher those that of SCr and BUN.Conclusion The detections of UMA and SCysC showed that they are sensitive indexes of early renal function injury.The conbined determination of UMA and SCysC is useful for early diagnosis and intervention for hypertension and diabeticnephropathy. 【Key words】 UMA; SCysC; glomerular filtration rate 高血压和糖尿病是引起早期肾功能损伤的主要原因［1］。据世界卫生组织预计,到2025年,糖尿病患者将达到3亿,其中2型糖尿病约占全部患者的85 %～90 %.它对患者的主要威胁就是肾脏损害，能阻止糖尿病和高血压肾功能早期损害的方法是早诊断、早治疗［2，3］。较多研究发现血清胱抑素C（serum Cystain C,SCysC）和尿微量白蛋白（microalbunminuria,UMA）是反映肾功能损害的敏感指标［4］。对此作者采用免疫透射比浊法和乳胶增强散射免疫比浊法分别检测UMA和SCysC浓度,和传统的肾功能指标检测指标血清肌酐（serun creatinine,Scr）、尿素氮（blood urea nitrogen,BUN）做比较,探讨UMA、SCysC以及它们的联合检测在诊断高血压和糖尿病继发肾功能损伤时的应用价值［5，6］。 1 材料与方法 1.1 研究对象 高血压组:2008年绵阳市中医院门诊和住院病人中,尿常规检测蛋白为阴性的临床确诊原发性高血压患者264例,男153例,女111例;年龄40～75岁,平均57.5±17.5岁。高血压诊断标准为2004年WHO/ISH高血压诊断标准,收缩压≥18.6 kPa(140 mmHg),舒张压≥11.97 kPa(90 mmHg),排除肥胖、冠心病、糖尿病、严重的肝肾功能不全及继发性高血压。 糖尿病组:尿常规检测尿蛋白为阴性的临床确诊糖尿病患者225例,男121例,女104例,年龄38～75岁。平均5