摘要
目的探究凝血四项结合血清胱抑素C(cystatin C,CysC)水平测定用于老年高血压患者早期肾损伤预测的价值。方法选取2021年2月至2022年8月山东大学章丘区中医医院收治的120例老年高血压患者作为研究对象,依据肾小球滤过率分为对照组(80~100 ml/min,n=77)与观察组(<80 ml/min,n=43)。比较两组活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)、凝血酶时间(thrombin time,TT)、纤维蛋白原(fibrinogen,Fg)、CysC水平;绘制受试者工作特征(receiver operating characteristic,ROC)曲线,并计算曲线下面积(area under the curve,AUC),分析APTT、PT、TT、Fg、CysC单独及联合检测对高血压肾损伤的预测价值;分析Fg、CysC、联合检测在高血压肾损伤中的诊断效能。结果两组APTT、PT、TT比较差异无统计学意义;观察组Fg、CysC水平均高于对照组,差异有统计学意义(P<0.05)。ROC曲线显示,APTT、PT、TT、Fg、CysC单独及联合检测预测高血压肾损伤的AUC分别为0.519、0.579、0.583、0.671、0.653及0.990。联合检测诊断高血压肾损伤的灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于Fg、CysC单一检测,差异有统计学意义(P<0.017)。结论通过检测老年高血压患者Fg和CysC表达水平可准确反映高血压肾损伤情况,凝血四项和CysC联合检测对高血压肾损伤的诊断效能更高,对高血压治疗和肾损伤预防具有重要意义。
Objective To explore the value of four coagulation factors combined with serum cystatin C(CysC)level determination in predicting early renal injury in elderly hypertensive patients.Methods A total of 120 elderly hypertensive patients admitted to Ji'nan Zhangqiu District Hospital of TCM from February 2021 to August 2022 were selected as the study subjects,and they were divided into the control group(80-100 ml/min,n=77)and the observation group(<80 ml/min,n=43)according to the glomerular filtration rate.Activated partial thromboplastin time(APTT),prothrombin time(PT)and thrombin time(TT)fibrinogen(Fg),CysC levels were compared between the two groups.The receiver operating characteristic(ROC)curve was drown and area under the curve(AUC)was calculated,the predictive value of APTT,PT,TT,Fg and CysC alone and combined detection in hypertensive renal damage was analyzed;the diagnostic efficacy of Fg,CysC and combined detection in hypertensive renal damage was analysed.Results There were no significant differences in APTT,PT and TT between the two groups.The levels of Fg and CysC in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).ROC curve showed that the AUC of APTT,PT,TT,Fg and CysC alone and combined detection in predicting hypertensive renal damage were 0.519,0.579,0.583,0.671,0.653 and 0.990,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of combined detection for diaguosing hypertensive renal damage were higher than those of Fg and CysC single detection,and the differences were statistically significant(P<0.017).Conclusion The expression levels of Fg and CysC in elderly patients with hypertension can accurately reflect the renal injury caused by hypertension,the combined detection of four coagulation factors and CysC has a higher diagnostic efficacy for renal injury caused by hypertension and is of great significance for the treatment of hypertension and the prevention of renal damage.
作者
何祖玲
王贺
叶迎新
HE Zuling;WANG He;YE Yingxin(Department of Laboratory,Ji'nan Zhangqiu District Hospital of TCM,Ji'nan,Shandong,250200,China;Department of Internal Medicine,Zhangqiu District Maternal and Child Health Hospital,Jinan City,Ji'nan,Shandong,250200,China;Department of Encephalopathy,Ji'nan Zhangqiu District Hospital of TCM,Ji'nan,Shandong,250200,China)
出处
《当代医学》
2025年第2期39-44,共6页
Contemporary Medicine
关键词
凝血四项
老年
高血压
早期肾损伤
血清胱抑素C
纤维蛋白原
凝血酶
Four coagulation factors
Old age
Hypertension
Early renal injury
Serum cystatin C
Fibrinogen
Thrombin
