摘要
目的分析和评估血清胱抑素C(CysC)和β2微球蛋白(β2-MG)在老年慢性阻塞性肺病(COPD)患者早期肾损伤的监测意义。方法分组:COPD组60例(平均年龄68岁),对照组(健康体检者,平均年龄65岁)30例;依据缺氧程度分为轻、中、重度缺氧3组;再依据心脏彩色多普勒超声中肺动脉收缩压分为无肺动脉高压和有肺动脉高压两组。测定血清β2-MG、视黄醇结合蛋白(RBP)、CysC、血清肌酐(Scr)、尿素氮(BUN)、估算肾小球滤过率(eGFR)。结果 (1)与对照组比较,COPD组血清β2-MG、CysC明显增高,eGFR降低,差异均有统计学意义(P<0.05)。而血清Scr、BUN、RBP与对照组比较差异无统计学意义。(2)血清CysC和β2-MG在COPD组均高于对照组,二者在重度缺氧组增高的比例明显高于在轻度和重度缺氧组,二者在重度缺氧组增高的比例明显高于在COPD组(P<0.05)。(3)血清CysC和β2-MG在无肺动脉高压组及肺动脉高压组的浓度均明显高于对照组,增高的比例分别是36.7%和43.3%,二者在肺动脉高压组增高的比例明显高于无肺动脉高压组,差异均有统计学意义(P<0.05)。(4)相关性分析提示,在COPD组,血清β2-MG、CysC的增高与氧分压(SPO2)均存在良好负性相关(r值分别是-0.702和-0.680,P值为0.000),β2-MG相关系数大于CysC。结论 COPD可致患者肾功能损伤。血清CysC、β2-MG是评估COPD患者早期肾损害的灵敏指标,并与SPO2存在负相关,随缺氧程度加重,血清中β2-MG、CysC浓度增高,其中β2-MG在COPD患者中较CysC与SPO2相关性更好。
Objective To study and evaluate the significance of CystatinC（CysC） and beta2-microglobulin（β2-MG） in the early detection of renal injury in senior COPD.Methods We prospectively enrolled 60 patients with COPD as COPD group（average age：68 years）.and 30 normal people as control group（average age：65 years）.The COPD group was further divided into three groups according to hypoxia levels（mild,medium,and severe hypoxia groups）;and into two groups according to pulmonary arterial pressure levels（with or without pulmonary hypertension groups）.Routine laboratory markers of kidney injury were detected from blood sample,which include BUN,Scr,retinol binding protein（RBP）,β2-MG,cystatin C（CysC）;and eGFR was calculated using the CKDEPI formula.Results The serum Scr,BUN,RBP were not significantly different between COPD and control groups.However the levels of serum CysC,β2-MG and the eGFR in COPD group were significantly changed（compared to the control group）（P0.05）.The levels of serum CysC and β2-MG were significant higher in the three hypoxia subgroups compared to control group（P0.05）.The increased ratios in CODP group are 42.67% and 45% respectively.There is a highest ratio in the severe hypoxia groups（vs mild and medium hypoxia groups,P0.05）.The same results showed in pulmonary hypertension group and no pulmonary hypertension group.Furthermore,in the correlation analysis,β2-MG and CysC was negatively correlated with hypoxia levels in COPD group.Conclusions The levels of serum Cystatin C,β2-MG are sensitive marker to detect early renal injury in COPD.Both cystatin C and β2-MG have negative correlations with hypoxia levels in COPD.In comparison the serum β2-MG may be more sensitive than Cys C for evaluation of early stage renal injury in COPD.
出处
《中华保健医学杂志》
2013年第2期106-109,共4页
Chinese Journal of Health Care and Medicine
基金
宁夏科技攻关项目(201117)
