摘要
目的探讨慢性肾脏病(CKD)并发冠心病(CHD)患者尿酸(UA)/白蛋白(Alb)比值(UAR)的水平变化及临床意义。方法175例CKD患者分为单纯CKD(对照)组94例和并发CHD(试验)组81例。比较2组血常规、血脂、肾功能及UAR差异。二元Logistic回归分析CKD并发CHD的影响因素。受试者工作特征(ROC)曲线分析各指标对CKD并发CHD的预测价值。结果2组间白细胞计数(WBC)、单核细胞(Mon)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的差异无统计学意义。试验组中性粒细胞(Neu)、红细胞分布宽度变异系数(RDW-CV)、尿素氮(BUN)、肌酐(Cr)、UA、UAR水平高于对照组(Ρ<0.05);淋巴细胞(Lym)、红细胞计数(RBC)、平均红细胞血红蛋白浓度(MCHC)、血小板计数(PLT)、估算肾小球滤过率(eGFR)、Alb水平低于对照组(Ρ<0.05)。二分类Logistic回归分析显示,较低水平的RBC、MCHC及较高水平的UAR是CKD并发CHD的独立危险因素。ROC曲线显示,RBC、MCHC、UAR单独检测中UAR曲线下面积(AUC)最大,为0.912(95%CI:0.870~0.953),敏感度0.901,特异度0.777,约登指数0.678,截断值10.935。三者联合检测AUC为0.987(95%CI:0.974~0.999),敏感度0.938,特异度0.979。结论CKD患者血清UAR水平升高是预测冠心病发生的预测指标,UAR联合RBC和MCHC预测效能更高。
Objective To investigate the clinical significance and level changes of uric acid(UA)/albumin(ALB)ratio(UAR)in patients with chronic kidney disease(CKD)complicated with coronary heart disease(CHD).Methods A total of 175 patients with CKD were divided into the simple CKD group(control group,n=94)and the CKD complicated with CHD group(experimental group,n=81).The differences of blood routine,blood lipid,renal function and UAR were compared between the two groups.The influencing factors of CKD complicated with CHD were analyzed by binary Logistic regression.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of each index for CKD complicated with CHD.Results There were no significant differences in white blood cell count(WBC),monocytes(Mon),total cholesterol(TC),total triglyceride(TG),high-density lipoprotein(HDL-C)and low-density lipoprotein(LDL-C)between the two groups.The levels of neutrophils(Neu),red cell distribution width variation coefficient(RDW-CV),blood urea nitrogen(BUN),creatinine(Cr),UA and UAR levels were higher in the experimental group than those in the control group(Ρ<0.05).The levels of lymphocyte(Lym),red blood cell count(RBC),mean corpuscular hemoglobin concentration(MCHC),platelet(PLT),estimated glomerular filtration rate(eGFR)and albumin(Alb)were lower in the experimental group than those in the control group(Ρ<0.05).Logistic regression analysis showed that lower levels of RBC and MCHC,and higher levels of UAR were independent risk factors for CKD complicated with CHD.ROC curve showed that the area under the UAR curve was the largest in RBC,MCHC and UAR detection,which was 0.912(95%CI:0.870-0.953),the sensitivity was 90.10%,the specificity was 77.70%,the Yoden index was 0.678 and the cutoff value was 10.935.The AUC of combined detection of RBC,MCHC and UAR was 0.987(95%CI:0.974-0.999),the sensitivity was 93.80%and the specificity was 97.90%.Conclusion The increased serum UAR level in patients with CKD is a predictor of CHD.The combined detection of UAR,RBC and MCHC has higher prediction efficiency.
作者
顾芸芸
仲崇明
杨海燕
GU Yunyun;ZHONG Chongming;YANG Haiyan(Department of Laboratory Medicine,Affiliated Lianyungang Hospital,Nanjing University of Chinese Medicine,Lianyungang 222004,China;Department of Laboratory Medicine,the First Affiliated Hospital of Kangda College of Nanjing Medical University/the First People’s Hospital of Lianyungang)
出处
《天津医药》
CAS
2024年第11期1202-1206,共5页
Tianjin Medical Journal
