尿白蛋白/肌酐比值联合血清CysC评估慢性肾脏病肾功能损害程度的预测价值OA
Predictive Value of Urinary Albumin-to-Creatinine Ratio Combined with Serum Cystatin C for Assessing the Degree of Renal Function Impairment in Chronic Kidney Disease
目的 探讨尿白蛋白/肌酐比值与血清半胱氨酸蛋白酶抑制剂 C(CysC)联合检测对慢性肾脏病(CKD)肾功能损害程度的预测价值.方法 采用回顾性研究,选择 2022 年 2 月至 2025 年 2 月安阳市第六人民医院收治的 CKD 患者100例,根据CKD分期,将患者分为轻度损害组(63例,CKD分期1～3期)和重度损害组(37例,CKD分期4～5期).比较两组临床资料,采用多因素二元 Logistic 回归分析 CKD 肾功能损害程度的影响因素,绘制受试者工作特征(ROC)曲线评估尿白蛋白/肌酐比值、血清 CysC 单项及联合检测对 CKD 肾功能损害程度的预测价值.结果 重度损害组血清Hb 水平低于轻度损害组,尿白蛋白/肌酐比值及血清 CysC 水平高于轻度损害组,差异均有统计学意义(P＜0.05).多因素二元 Logistic 回归分析结果显示,尿白蛋白/肌酐比值及血清 CysC 水平均与 CKD 患者重度肾功能损害独立相关(P＜0.05).ROC 曲线分析结果显示,尿白蛋白/肌酐比值与血清 CysC 联合检测预测 CKD 肾功能损害程度的曲线下面积(AUC)高于任一单项指标检测(Z尿白蛋白/肌酐比值=2.948,ZCysC=4.292,均P＜0.05).结论 尿白蛋白/肌酐比值及血清 CysC 水平与 CKD 肾功能损害程度密切相关,可作为评估 CKD 肾功能损害程度的重要指标;两者联合检测对CKD 肾功能损害程度具有较高的预测价值.
Objective To investigate the predictive value of the combined detection of urinary albumin-to-creatinine ratio and serum cystatin C(CysC)for the degree of renal function impairment in patients with chronic kidney disease(CKD).Methods Using a retrospective study design,100 patients with CKD admitted to The Sixth People's Hospital of Anyang from February 2022 to February 2025 were selected.According to CKD staging,the patients were divided into a mild impairment group(63 cases,CKD stages 1～3)and a severe impairment group(37 cases,CKD stages 4～5).Clinical data were compared between the two groups.Multivariate binary logistic regression was used to analyze the factors influencing the degree of renal function impairment in CKD,and receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of urinary albumin-to-creatinine ratio alone,serum CysC alone,and their combined detection for the degree of renal function impairment in CKD.Results The serum hemoglobin(Hb)level in the severe impairment group was lower than that in the mild impairment group,while the urinary albumin-to-creatinine ratio and serum CysC level were higher than those in the mild impairment group,and the differences were statistically significant(P＜0.05).Multivariate binary logistic regression analysis showed that both the urinary albumin-to-creatinine ratio and serum CysC level were independently associated with severe renal function impairment in patients with CKD(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of the combined detection of urinary albumin-to-creatinine ratio and serum CysC for predicting the degree of renal function impairment in CKD was higher than that of either single indicator alone(Zurinary albumin-tO-creatinine ratiO=2.948,ZCysC=4.292,P＜0.05).Conclusion The urinary albumin-to-creatinine ratio and serum CysC level are closely associated with the degree of renal function impairment in CKD and can serve as important indicators for assessing the degree of renal function impairment in CKD.Their combined detection has high predictive value for the degree of renal function impairment in CKD.
程高峰;章瑾;李俊强
安阳市第六人民医院 医学检验科,河南 安阳 455000安阳市第六人民医院 医学检验科,河南 安阳 455000安阳市第六人民医院 医学检验科,河南 安阳 455000
慢性肾脏病尿白蛋白/肌酐比值血清半胱氨酸蛋白酶抑制剂C肾功能损害程度
chronic kidney diseaseurinary albumin-to-creatinine ratioserum cystatin Cdegree of renal function impairment
《临床研究》 2026 (4)
133-137,5
2020年河南省医学科技攻关计划联合共建项(LHGJ20200290).
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