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目的 :探讨半胱氨酸蛋白抑制物C(CystatinC)用于原发性高血压患者肾功能损伤及肾血流有关检测分析中的应用。方法 :应用乳胶颗粒增强比浊法、放射免疫、酶标法和彩色多普勒超声法检测 6 2例患者的血浆CystatinC、ET、尿肾功能早期损伤四项指标和肾血流。结果 :将患者组分为CystatinC阴性组和阳性组 ,ET在正常组与阳性组之间存在显著差异 (p <0 0 5 ) ;两个患者组与 32例正常对照组比较 ,肾功能早期损伤四项指标均有非常显著的差异 (p <0 0 1) ,患者组之间也存着非常显著的差异 (p <0 0 1) ;两个患者组的肾动脉血流检查结果与正常对照组均有不同程度的改变 ,但患者组之间无显著差异 ;患者组随着肾小球滤过功能的下降 ,Scr明显增高、BUN无差异。结论 :当原发性高血压患者血浆CystatinC正常时 ,肾血流由于肾自身调节功能的存在而发生明显改变 ,尽管GFR未见异常、血Scr和Urear也正常 ,但肾功能早期损伤 ,特别是肾小管损伤已出现。随着病程的进一步发展 ,血浆CystatinC明显增高 ,说明肾功能进入失代偿阶段 ,其表现为肾血流有关指标已不产生进一步变化 ,肾小球、肾小管及Scr等有关指标均出现非常明显的恶化。
Objective: To investigate the application of cystatin C in renal damage and renal blood flow in patients with essential hypertension. Methods: Cystatin C, ET, early indicators of urinary renal injury and renal blood flow were detected in 62 patients by latex particle turbidimetry, radioimmunoassay, enzyme labeling and color Doppler ultrasonography. Results: The patients were divided into CystatinC negative group and positive group, there was a significant difference between normal group and positive group (p <0.05). Two groups of patients were compared with 32 normal control group, early renal injury There were significant differences among the four indicators (p <0.01), with significant differences between the patient groups (p <0.01); the results of renal artery flow tests in the two patient groups were similar to those of the normal controls Group had varying degrees of change, but no significant difference between the patient groups; patients with glomerular filtration rate decreased, Scr was significantly increased, BUN no difference. CONCLUSION: When the plasma Cystatin C is normal in patients with essential hypertension, the renal blood flow changes obviously due to the existence of renal autoregulation. Although there is no abnormality of GFR and blood Scr and Urear are also normal, early renal injury, especially Tubular injury has occurred. With the further development of the course, the plasma CystatinC was significantly increased, indicating that renal function into the decompensated phase, the performance of the renal blood flow has not changed further indicators, glomerular, tubular and Scr and other indicators were very obvious The deterioration.