摘要
目的探讨肾动脉阻力指数(renal artery resistance index,RRI)在不同时期慢性肾脏病(chronic kidney disease,CKD)患者中的变化及其与早期肾功能损伤指标之间的相关性。方法收集2016年1月至2020年9月在海南医学院第一附属医院就诊的CKD患者611例的临床资料并作为病例组,根据CKD-EPI Scr方程计算出估算肾小球滤过率,依照CKD分期将病例组分成5组。另选择健康体检者100名作为对照组。分别测定各组RRI以及血清β2-微球蛋白(β2-microglobulin,β2-MG)、血清胱抑素C(cystatin C,CysC)、血肌酐、尿素氮。采用单因素方差分析对比病例组和对照组的组间差异;计算各组指标的异常检出率;采用受试者工作特征曲线分析上述指标对CKD患者的诊断效能。结果各病例组的RRI、β2-MG、CysC、血肌酐、尿素氮的均值较对照组明显升高(P<0.05)。在CKD1、2期中,RRI的异常检出率显著高于其他单项检测指标,且β2-MG、CysC与RRI三者并联检测的异常检出率高于任一单项检测指标。ROC曲线显示,单项检测指标中以RRI的曲线下面积和约登指数最大,联合检测中以β2-MG、CysC与RRI三者联检的AUC和约登指数最大。结论RRI、β2-MG、CysC尤其是RRI可作为CKD早期肾损害的敏感检测指标,三者联检能提高异常检出率和诊断效能,可为CKD患者的早期诊疗提供临床参考价值。
Objective To explore the changes of renal artery resistance index(RRI)in patients with chronic kidney disease(CKD)at different stages and examine its correlation with early renal function damage.Methods From January 2016 to September 2020,clinical data of 611 CKD patients were collected as case group.Estimated glomerular filtration rate(eGFR)was calculated by CKD-EPIscr equation.The case group was further divided into 5 groups according to CKD stage.Meanwhile 100 healthy volunteers in the same period were chosen as control group.RRI,serumβ2-microglobulin(β2-MG),serum cystatin C(CysC),serum creatinine(Scr)and serum urea nitrogen(BUN)were measured.The differences between case and control groups were compared by one-way ANOVA;the abnormal detection rate of each group was calculated;the diagnostic efficiency of the above indicators in CKD patients was analyzed by receiver operating characteristic(ROC)curve.Results The mean values of RRI,β2-MG,CysC,Scr and BUN were higher in each case group than those in control group(P<0.05).In stages 1 and 2,the abnormal detection rate ofβ2-MG,CysC and RRI was higher than that of any single detection index,followed by the abnormal detection rate of RRI.Receiver operating characteristic(ROC)curve showed that area under the curve(AUC)and Youden index of RRI were the largest in single detection indexand AUC and Youden index of combined detection ofβ2-MG,CysC and RRI were the largest.Conclusion RRI,β2-MG and CysC may be utilized as sensitive detection parameters of early renal damage in CKD,especially RRI.Combined detection ofβ2-MG,CysC and RRI can improve abnormal detection rate and boost diagnostic efficiency.Thus it provides clinical references for early diagnosis and treatment of CKD.
作者
朱永俊
俞容
曹彦卫
林子艳
杨静
高可利
王颖
崔红旺
Zhu Yong-jun;Yu Rong;Cao Yan-wei;Lin Zi-yan;Yang Jing;Gao Ke-li;Wang Ying;Cui Hong-wang(Department of Nephrology,First Affiliated Hospital,Hainan Medical University,Haikou 570100 China;Department of Nephrology,Bayan Nur Hospital,Bayan Nur 015000,China;Department of Orthopedics,First Affiliated Hospital,Hainan Medical University,Haikou 570100,China)
出处
《临床肾脏病杂志》
2021年第8期654-659,共6页
Journal Of Clinical Nephrology
基金
海南省重点研发计划科技合作方向项目(ZDYF2019215)
国家自然科学基金(82060143)
内蒙古自治区自然科学基金(2019MS08064)。
