摘要
目的分析血清胱抑素C(Cystatin C)联合尿红细胞位相检测在早期肾脏损伤筛查中的应用价值。方法选择23例未开展肾脏疾病筛查的糖尿病或高血压患者作为病例Ⅰ组,21例有肾病病史的患者作为病例Ⅱ组,20例无高血压、糖尿病及肾病病史的健康体检者作为对照组。三组采用免疫散射比浊法测定血清Cystatin C,采用相差显微镜在暗视野中观察尿红细胞形态。比较三组血清Cystatin C水平及异常形态红细胞比例,分析病例Ⅰ组血清Cystatin C联合尿红细胞位相检测的诊断效能及尿红细胞位相检测结果。结果病例Ⅰ组血清Cystatin C水平及异常形态红细胞比例分别为(1.01±0.39)mg/L、(63.4±9.7)%,病例Ⅱ组分别为(2.05±0.41)mg/L、(90.1±9.3)%,对照组分别为(0.81±0.32)mg/L、(34.3±5.7)%。病例Ⅱ组血清Cystatin C水平及异常形态红细胞比例均高于病例Ⅰ组、对照组,病例Ⅰ组高于对照组,差异具有统计学意义(P<0.05)。病例Ⅰ组确诊16例有肾脏损伤,7例无肾脏损伤。病例Ⅰ组血清Cystatin C联合尿红细胞位相检测的阳性率为73.9%(17/23),高于血清Cystatin C单独检测的43.5%(10/23)、尿红细胞位相单独检测的34.8%(8/23),差异具有统计学意义(χ^(2)=4.394、7.097,P<0.05);血清Cystatin C联合尿红细胞位相检测的诊断敏感性为93.8%(15/16),特异性为71.4%(5/7),阳性预测值为88.2%(15/17),阴性预测值为83.3%(5/6)。病例Ⅰ组23例患者中,检出尿红细胞形态异常12例(52.2%)。高倍镜下尿红细胞体积偏小、大小不等、形态多样不规则,常见有棘形红细胞、脱颗粒红细胞、环形红细胞、靶形红细胞、穿孔样红细胞等形,其中以棘形红细胞、环形红细胞、脱颗粒红细胞、小红细胞最多见,分别为10、9、8、5例。结论血清Cystatin C联合尿红细胞位相检测有利于糖尿病及高血压性肾脏损伤的早期筛查和诊断。
Objective To analyze the application value of serum Cystatin C combined with urinary red blood cell phase in screening of early renal diseases.Methods 23 patients with diabetes mellitus or hypertension who had not undergone kidney disease screening were included in the case group I,and 21 patients with a history of nephropathy were included in the case groupⅡ.Another 20 healthy subjects who had not undergone kidney disease screening were selected as the control group.The three groups of patients simultaneously used immunoturbidimetry to determine the serum Cystatin C and observed the morphology of urinary red blood cells with a phase contrast microscope in the dark field.The serum levels of Cystatin C and the proportion of abnormal red blood cell morphology of the three groups were compared,and the diagnostic efficacy of serum Cystatin C combined with urinary red blood cell phase and the results of urinary red blood cell phase were analyzed in case groupⅠ.Results The levels of serum Cystatin C and the proportion of abnormal red blood cell morphology in case groupⅠwere(1.01±0.39)mg/L and(63.4±9.7)%,those in case groupⅡwere(2.05±0.41)mg/L and(90.1±9.3)%,and those in the control group were(0.81±0.32)mg/L and(34.3±5.7)%.The serum level of Cystatin C and proportion of abnormal red blood cell morphology in case groupⅡwere higher than those in case groupⅠand control group,and case groupⅠwas higher than case groupⅡ.The differences were statistically significant(P<0.05).In case groupⅠ,16 cases were diagnosed with kidney injury and 7 cases without kidney injury.The positive rate of serum Cystatin C combined with urinary red blood cell phase in case groupⅠwas 73.9%(17/23),which was higher than that of 43.5%(10/23)of serum Cystatin C alone and 34.8%(8/23)of urinary red blood cell phase alone,and the differences were statistically significant(χ^(2)=4.394,7.097;P<0.05).The diagnostic sensitivity of serum Cystatin C combined with urine red blood cell phase was 93.8%(15/16),the specificity was 71.4%(5/7),the positive predictive value was 88.2%(15/17),and the negative predictive value was 83.3%(5/6).Of the 23 patients in case groupⅠ,12 cases(52.2%)were found to have abnormal red blood cell morphology in urine. Under high magnification microscope, urinary red blood cells were small in volume, varied in size and varied in shape. Spinous red blood cells, degranulated red blood cells, ring-shaped red blood cells, target-shaped red blood cells and perforated red blood cells were common, among which spinous red blood cells, ring-shaped red blood cells, degranulated red blood cells, microcyte were the most common, with 10, 9, 8, 5 cases, respectively. Conclusion The combination of serum Cystatin C and urinary red blood cell phase is beneficial to the early screening of diabetes mellitus and hypertensive renal injury.
作者
林碧芳
江清华
LIN Bi-fang;JIANG Qing-hua(Xiamen Haicang Hospital,Xiamen 361026,China)
出处
《中国现代药物应用》
2023年第24期92-94,共3页
Chinese Journal of Modern Drug Application
关键词
血清胱抑素C
尿红细胞位相
早期肾脏损伤
糖尿病
高血压
Serum Cystatin C
Urinary red blood cell phase
Early renal injury
Diabetes mellitus
Hypertension
