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预防医学  2017, Vol. 29 Issue (4): 338-341    DOI: 10.19485/j.cnki.issn1007-0931.2017.04.004
  论著 本期目录 | 过刊浏览 | 高级检索 |
氧化应激相关指标在慢性肾脏病诊断中的价值
杨叶青1,刘波2,徐广平2,陈小华2,毛显雅2
1.浙江中医药大学附属第二医院检验科,浙江杭州 310005;
2.浙江大学医学院附属第二医院
A study on the clinical value of oxidative stress related index in chronic kidney disease diagnosis
YANG Ye-qing, LIU Bo, XU Guang-ping, CHEN Xiao-hua, MAO Xian-ya
Clinical Laboratory of the Second Hospital Affiliated of Zhejiang Chinese Medicine University, Hangzhou,Zhejiang,310005, China
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摘要 目的 探讨氧化应激相关指标在慢性肾脏病(CKD)早期诊断和病情评估中的价值。方法 选择2014年8月—2015年12月在浙江大学医学院附属第二医院肾脏内科住院治疗的CKD患者220例,选择2015年12月在该医院体检正常的100人作为对照。分别测定两组血清肌酐(Cr)、尿酸(UA)、γ-谷氨酰转肽酶(GGT)、同型半胱氨酸(HCY)水平,并比较两组差异。根据Cr水平,估算肾小球滤过率(GFR),划定CKD临床分期。采用受试者工作特征(ROC)曲线比较CKD I、CKD II组患者和对照组UA、GGT、HCY单项检测及3项联合检测的准确性。结果 CKD组血清Cr、UA、GGT、HCY水平均高于对照组(P<0.05),在CKD组与对照组的鉴别诊断研究中,UA、GGT、HCY单项和3项联合检测的ROC曲线下面积(AUC)值分别为0.823、0.585、0.850和0.924,单项临床诊断价值均低于3项联合(P<0.05)。在CKDⅠ组与对照组的鉴别诊断研究中,UA、GGT、HCY单项和3项联合检测的AUC值分别为0.711、0.594、0.716和0.807,单项临床诊断价值均低于3项联合(P<0.05)。在CKDⅠ组与Ⅱ组的鉴别诊断研究中,3项联合检测的AUC值为0.834,与HCY单项检测的AUC值0.828相比,差异无统计学意义(P>0.05)。结论 UA、GGT、HCY 3项指标的联合检测在CKD早期临床诊断中具有较高的应用价值,在CKD晚期单独检测HCY与3项联合检测的诊断价值相近。
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杨叶青
刘波
徐广平
陈小华
毛显雅
关键词 慢性肾脏病氧化应激早期诊断    
AbstractObjective To evaluate the clinical value of oxidative stress related indicators in chronic kidney disease (CKD)diagnosis.Methods A total of 220 CKD patients in different stages and 100 healthy persons were enrolled. The serum levels of Creatinine (Cr), uric acid (UA),γ-glutamyl transpeptidase (GGT) and homocysteine (HCY) were measured. CKD patients were divided into 5 stages according to the calculated estimated glomerular filtration rate (eGFR). CKD patients in stage 1, 2 were incorporated as group CDKⅠand incorporating CKD patients in stage 3, 4, 5 patients were incorporated as group CDKⅡ.T test was used to compare the difference of UA, GGT, HCY levels between healthy people and CKD patients. Receiver operating characteristic (ROC) curve was used to evaluate the clinical value of each index in CKD diagnosis. Z test was used to compare the difference of the area under curve (AUC) of UA, GGT, HCY and combined detection.Results The mean levels of serum UA, GGT, HCY between CKD patients and healthy person were statistically significant (P<0.05). In healthy persons and CKD patients study, the AUC of UA, GGT, HCY and combined detection were 0.823, 0.585, 0.850 and 0.924, respectively. The AUC of combined detection was significantly higher than single detection (P<0.05). In group CDKⅠ andⅡ study, the AUC of UA, GGT, HCY and combined detection were 0.719, 0.485, 0.828 and 0.834, respectively. The AUC of combined detection was not significantly higher than HCY detection (P>0.05)Conclusion Combined detection of oxidative stress related index has high application value in CKD early diagnosis.
Key wordsChronic kidney disease;Oxidative stress    Early diagnosis
收稿日期: 2016-08-25           出版日期: 2017-04-15
中图分类号:  R692  
作者简介: 杨叶青,本科,检验技师,主要从事生化检验工作
通信作者: 毛显雅,E-mail:15305718303@163.com   
引用本文:   
杨叶青, 刘波, 徐广平, 陈小华, 毛显雅. 氧化应激相关指标在慢性肾脏病诊断中的价值[J]. 预防医学, 2017, 29(4): 338-341.
YANG Ye-qing, LIU Bo, XU Guang-ping, CHEN Xiao-hua, MAO Xian-ya. A study on the clinical value of oxidative stress related index in chronic kidney disease diagnosis. Preventive Medicine, 2017, 29(4): 338-341.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn1007-0931.2017.04.004      或      http://www.zjyfyxzz.com/CN/Y2017/V29/I4/338
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