Clinical value of urine and serum tumor markers combined detection in early renal damage in patients with primary hypertension / 中国综合临床

ABSTRACT

Objective To investigate the value of combined detection of serum cystatin C(Cys-C),alpha 1- microspheres(α1-MG)and urinary microalbumin(mAlb)in the early stage of renal damage in patients with primary hypertension(PH).Methods One hundred and twenty-eight patients with PH were divided into 3 groups according to urinary albumin excretion rate(UAER),group I,normal proteinuria,47 cases,group II microalbuminuria,43 cases,group III,massive proteinuria,38 cases and 50 healthy subjects(the control group)served as research object.Hitachi 7180 automatic biochemical analyzer was applied with latex turbidimetric immunoassay to detect serum Cys-C,α1-MG and mAlb,serum creatinine(Crea)and serum urea (Urea)were determined by enzyme method.Comparative analysis on the early diagnosis efficiency of renal damage was made o based on the combined detection results.Results PH patients were tested by Cys-C( (0.98±0.13)mg/L vs.(1.62±0.55)mg/L vs.(3.17±1.04)mg/L),α1-MG((29.32±6.46)mg/L vs. (38.58±11.79)mg/L vs.(61.42±22.71)mg/L),mAlb((26.35±6.53)mg/24 h vs.(54.24±12.78)mg/24 h vs.(373.6±98.40)mg/24 h),Crea((5.06±0.67)μmol/L vs.(89.64±28.84)μmol/L vs.(164.16 ±58.77)μmol/L),Urea((5.06 ± 0.67)mmol/L vs.(7.87 ± 2.95)mmol/L vs.(15.10 ± 7.41)mmol/L, compared with those in the control group((0.69±0.08)mg/L,(17.15±4.30)mg/L,(19.55±4.28)mg/24 h,(68.39±20.11)μmol/L,(5.05±0.78)mmol/L,there were significant differences among the four groups(F=164.74,93.01,553.27,61.38,65.24,P=0).The results of Cys-C,α1-MG and mAlb in patients with PH were higher than those in the control group(P<0.05,P<0.01).The results of Cys-C,α1-MG and mAlb in group II were higher than those in group I,but lower than those in group III(P<0.01).The detection results of Crea in group I and group II were higher than those in the control group(P>0.05),but lower than that in group III(P<0.05).The result of Urea in group I was higher than that in the control group(P>0.05),but lower than those in group II and group III(P<0.05).Crea Cys-C and Urea were positively correlated(r=0.385,r=0.310,P=0.006,P=0.025),α1-MG was positively correlated with Crea,Urea(r=0.310,r=0.228,P=0.028,P=0.043); mAlb was positively correlated with Crea and Urea(r=0.382,r=0.302,P=0.006,P=0.033). The specificity of combined detection of three markers(55.3%)was lower than the individual detection(74.5%,68.1%,80.9%)and also lower than the two-unit(70.2%,63.8%,index 78.7%); its sensitivity(90.7%)was significantly higher than that of the individual detection(65.1%,58.1%,67.4%)and the two-unit(79.1%,74.4%,69.8%).Conclusion Cys-C,α1-MG and mAlb can be used as important indicators in the diagnosis in the patients with PH renal damage,which can increase the effectiveness PH early renal damage diagnosis,can be used for early detection of renal damage in PH patients,with the disease monitoring.