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慢性肾脏病各期唾液酸、同型半胱氨酸及胱抑素C水平的变化及其临床意义
作者:周美文1 2  徐元宏1 
单位:1. 安徽医科大学第一附属医院 检验科, 安徽 合肥 230022;
2. 铜陵市立医院 检验科, 安徽 铜陵 244000
关键词:胱抑素C 同型半胱氨酸 唾液酸 慢性肾脏病 
分类号:R692
出版年·卷·期(页码):2016·35·第四期(565-568)
摘要:

目的:探讨慢性肾脏病(CKD)各期胱抑素C(CysC)、同型半胱氨酸(Hcy)、唾液酸(SA)的水平变化。方法:选择CKD病人129例(CKD 1期31例,2期18例,3期17例,4期12例,5期51例)作为研究组,同期健康体检者32例作为对照组,收集研究对象CysC、Hcy、SA数据进行统计分析。结果:CKD各期Hcy、CysC、SA逐渐升高,与对照组间差异均有统计学意义。其中CysC在CKD各期间差异均有统计学意义;Hcy在CKD 5期与1、2、3期间差异具有统计学意义,2、3、4期间差异无统计学意义,1期与2、3、4、5期间差异均有统计学意义;SA在CKD 5期与1、2、3、4期间差异均有统计学意义;Spearman相关性分析显示,Hcy、SA、CysC与eGFR均呈负相关(r=-0.606,P=0.000;r=-0.571,P=0.000;r=-0.911,P=0.000);Logistic回归分析显示,以eGFR为因变量,CysC(OR=29.816,95%CI为7.490~118.69,P=0.000)和Hcy(OR=1.107,95%CI为1.024~1.198,P=0.011)具有统计学意义。结论:CysC与Hcy是CKD开始恶化的独立危险因素;SA对CKD进展到终末期的判定具有临床意义。

Objective:To study the changes of cystatin C(CysC), homocysteine(Hcy) and sialic acid(SA) levels in different stages of chronic kidney disease(CKD). Methods:One hundred and twenty-nine patients with CKD were selected as study subjects, of whom 31 were in CKD stage 1, 18 in stage 2, 17 in stage 3, 12 in stage 4 and 51 in stage 5, and 32 healthy persons were served as the controls. Their clinical data were collected and statistically analyzed. Results:The levels of Hcy, CysC and SA increased gradually in CKD stages, and the differences between the subject group and the control group were statistically significant. The differences of CysC between the stages were statistically significant in all stages of CKD; the differences of Hcy were statistically significant between the stage 5 of CKD and stage 1, 2 and 3, while the differences among stage 2, 3 and 4 were statistically insignificant, and the differences between stage 1 of CKD and the other 4 stages were statistically significant.The differences of SA were statistically significant between stage 5 and the other 4 stages. Spearman relativity analysis showed that Hcy, SA and CysC were negatively correlated with eGFR(r=-0.606, P=0.000;r=-0.571, P=0.000;r=-0.911, P=0.000).eGFR as the dependent variable, Logistic regression analysis showed that CysC(OR=29.816, 95%CI=7.490-118.69, P=0.000) and Hcy(OR=1.107, 95%CI=1.024-1.198, P=0.011) have statistical significance. Conclusion:CysC and Hcy are independent risk factors for the deterioration of CKD. SA has clinical significance in the diagnosis of CKD at the final stage.

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