江玮
【摘要】 目的:探讨血清胱抑素C(Cys-C)和视黄醇结合蛋白(RBP)联合检测在慢性肾脏病(CKD)早期肾功能损伤中的诊断价值。方法:将笔者所在医院2018年1-12月收治的52例CKD早期肾功能损伤患者设为观察组,将同期在笔者所在医院体检中心进行体检的健康者52例设为对照组,研究血清Cys-C、RBP诊断价值。结果:观察组血清Cys-C、RBP水平高于对照组(P<0.05);CKD早期肾功能损伤患者中联合检测阳性率高于单独检测Cys-C、RBP(P<0.05);且CKD早期肾功能损伤患者血清Cys-C与RBP水平呈正相关(P<0.05)。结论:血清Cys-C联合RBP在CKD早期肾功能损伤患者的诊断应用中,其阳性检出率高于任一单项检测,二者具有相关性,具有临床诊断价值。
【关键词】 血清Cys-C 血清RBP CKD早期肾功能 阳性检出率
[Abstract] Objective: To investigate the diagnostic value of serum cystatin C (Cys-c) and retinol binding protein (RBP) in early renal injury in chronic kidney disease (CKD). Method: A total of 52 patients with early renal impairment of CKD admitted to our hospital from January to December 2018 were set as the observation group, and 52 healthy patients who underwent physical examination in the physical examination center of our hospital during the same period were set as the control group. The diagnostic value of serum Cys-c and RBP levels were studied. Result: Serum levels of Cys-c and RBP were higher in the observation group than those in the control group (P<0.05). The positive rate of combined detection in patients with early renal function injury of CKD was higher than the positive rate of single detection of Cys-C or RBP (P<0.05). Moreover, serum Cys-c was positively correlated with RBP level in patients with early renal impairment of CKD (P<0.05). Conclusion: In the diagnosis and application of serum Cys-c combined with RBP in patients with early renal function injury of CKD, the positive detection rate is higher than that of any single test. And they are correlated, which has clinical diagnostic value.
慢性肾脏病(CKD)是指各种原因引起的慢性肾脏结构及功能障碍,且肾功能损伤病史超过3个月,内容包括肾脏不正常的病理损伤、血液或尿液检查成分异常等,患者多表现为食欲不振、恶心、呕吐等[1]。对CKD早期肾功能损伤的发现和干预,可以降低患者的多种并发症发生率,提高患者的生存率[2]。目前临床对CKD早期肾功能损伤的诊断指标虽然多,但是对CKD早期肾功能损害指标的多数敏感性及检出率仍有不足[3]。因此,本文将血清胱抑素C(Cys-C)和视黄醇结合蛋白(RBP)检测应用于CKD早期肾功能损伤的诊断中,并分析其临床应用价值,现报告如下。
1 资料与方法
1.1 一般资料
纳入标准:(1)临床或个人资料完整;(2)无严重心脑血管疾病;(3)认知功能正常,无精神类障碍。排除标准:(1)糖尿病、高血压等慢性疾病者;(2)严重肝脏类疾病;(3)急性感染者。参与此次研究人员均为自愿,且签署知情同意书。选取笔者所在医院2018年1-12月收治的52例CKD早期肾功能损伤患者设为观察组,其中,男30例,女22例;年龄24~72岁,平均(50.6±2.8)岁,均符合CKD早期肾功能损伤的临床诊断标准及影像学检查结果。选取同期在笔者所在医院体检中心进行体检的健康者52例设为对照组,其中,男32例,女20例;年龄23~70(50.2±3.1)岁。两组性别、年龄比较,差异无统计学意义(P>0.05),有可比性。
1.2 检测方法
采集受检者晨起空腹静脉血3 ml,分离血清,保存温度
-20 ℃;使用全自动生化分析仪(北京普朗新技术有限公司,型号:SMT100)进行检测:采用血清Cys-C检测试剂盒(上海酶联生物科技有限公司)检测血清Cys-C,正常参考区间为0.56~1.22 mg/L;采用RBP檢测试剂盒(上海通蔚科技有限公司)检测RBP,正常参考区间为25~70 mg/L。检测方法均为免疫比浊法。