无症状肾源性血尿患者虚实证预测指标的初步筛选
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摘要
目的初步筛选无症状肾源性血尿患者虚实辨证的实验室预测指标。方法采集257例无症状肾源性血尿患者临床资料,包括患者年龄、性别、病程、合并症、血压、尿隐血、尿蛋白、尿沉渣、尿微量白蛋白(m Alb)、糖化血红蛋白、24小时尿蛋白定量、球蛋白(GLO)、血糖、尿素、肌酐、胱抑素C、白蛋白、胆固醇、甘油三脂、尿酸、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血红蛋白(Hb)、超敏C反应蛋白、血沉、补体C3、补体C4、IgA、IgG、IgM、全血黏度、血浆黏度等指标。同时由两位高级职称中医师对患者进行虚实辨证,根据辨证结果将患者分为虚证组及非虚证组,实证组和非实证组。比较虚证组与非虚证组、实证组与非实证组各指标的差异。用二元Logistic回归得出对虚证、实证候诊断有独立预测意义的指标。结果 257例患者中虚证组157例,非虚证组100例。与非虚证患者相比较,虚证患者在性别、病程、收缩压、m Alb <20 mg/L、尿沉渣5万/ml～50万/ml、糖化血红蛋白、GLO、甘油三脂、尿酸、HDL-C、Hb、IgG方面,差异具有统计学意义(P <0. 05),其中m Alb、GLO在独立预测无症状肾源性血尿虚证时具有统计学意义(P <0. 05)。实证组患者32例,非实证组225例。与非实证患者比较,实证组在性别、Hb、LDL-C方面差异有统计学意义(P <0. 05或P <0. 01),其中Hb和LDL-C在独立预测无症状肾源性血尿实证时具有统计学意义(P <0. 05)。结论 m Alb、GLO可作为无症状肾源性血尿虚证诊断的独立预测指标,Hb和LDL-C可作为无症状肾源性血尿实证诊断的独立预测指标。
Objective To preliminarily screen out the forecast indicators of deficiency and excess of syndrome in patients with asymptomatic nephrogenic hematuria. Methods Clinical data of 257 patients with asymptomatic nephrogenic hematuria,including age,gender,course of disease,comorbidities,blood pressure,urinary occult blood,urine protein,urine sediment,urinary microalbumin(m Alb),glycated hemoglobin,24-hour urine protein quantitative,globulin(GLO),blood glucose,urea,creatinine,cystatin C,albumin,cholesterol,triglycerides,uric acid,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),hemoglobin(Hb),hypersensitive C-reactive protein,erythrocyte sedimentation rate,complement C3,complement C4,IgA,IgG,IgM,whole blood viscosity,plasma viscosity and other indicators were collected. At the same time,by two doctors with senior titles,patients were divided into two groups according to the results of syndrome differentiation: the deficiency group and the non-deficiency group,the excess group and the non-excess group. The differences of the indicators among the deficiency group and the non-deficiency group,the excess group and the non-excess group were compared. Binary logistic regression was used to obtain indicators with independent predictive significance for the diagnosis of deficiency syndrome and excess syndrome. Results Among the 257 patients,there were 157 cases in the deficiency group and 100 cases in the non-deficiency group. Compared with patients with non-deficiency syndrome,there were statistically significant differences in gender,disease duration,systolic blood pressure,m Alb < 20 mg/L,urinary sediment from 50, 000/mL to 500, 000/mL,glycosylated hemoglobin,GLO,triglyceride,uric acid,HDL-C,Hb and IgG of patients with deficiency syndrome(P < 0. 05),and m Alb and GLO were statistically significant for independently predicting asymptomatic nephrogenic hematuria(P < 0. 05). There were 32 cases in excess group,and225 cases in non-excess group. Compared with the non-excess group,the differences in gender,Hb,and LDL-C of excess group were statistically significant(P < 0. 05 or P < 0. 01),and Hb and LDL-C were statistically significant in predicting asymptomatic nephrogenic hematuria with excess syndrome(P < 0. 05). Conclusion m Alb and GLO can be used as independent predictors for the diagnosis of asymptomatic nephrogenic hematuria. Hb and LDL-C can be used as independent predictors for the diagnosis of asymptomatic nephrogenic hematuria.
Objective To preliminarily screen out the forecast indicators of deficiency and excess of syndrome in patients with asymptomatic nephrogenic hematuria. Methods Clinical data of 257 patients with asymptomatic nephrogenic hematuria,including age,gender,course of disease,comorbidities,blood pressure,urinary occult blood,urine protein,urine sediment,urinary microalbumin(m Alb),glycated hemoglobin,24-hour urine protein quantitative,globulin(GLO),blood glucose,urea,creatinine,cystatin C,albumin,cholesterol,triglycerides,uric acid,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),hemoglobin(Hb),hypersensitive C-reactive protein,erythrocyte sedimentation rate,complement C3,complement C4,IgA,IgG,IgM,whole blood viscosity,plasma viscosity and other indicators were collected. At the same time,by two doctors with senior titles,patients were divided into two groups according to the results of syndrome differentiation: the deficiency group and the non-deficiency group,the excess group and the non-excess group. The differences of the indicators among the deficiency group and the non-deficiency group,the excess group and the non-excess group were compared. Binary logistic regression was used to obtain indicators with independent predictive significance for the diagnosis of deficiency syndrome and excess syndrome. Results Among the 257 patients,there were 157 cases in the deficiency group and 100 cases in the non-deficiency group. Compared with patients with non-deficiency syndrome,there were statistically significant differences in gender,disease duration,systolic blood pressure,m Alb < 20 mg/L,urinary sediment from 50, 000/mL to 500, 000/mL,glycosylated hemoglobin,GLO,triglyceride,uric acid,HDL-C,Hb and IgG of patients with deficiency syndrome(P < 0. 05),and m Alb and GLO were statistically significant for independently predicting asymptomatic nephrogenic hematuria(P < 0. 05). There were 32 cases in excess group,and225 cases in non-excess group. Compared with the non-excess group,the differences in gender,Hb,and LDL-C of excess group were statistically significant(P < 0. 05 or P < 0. 01),and Hb and LDL-C were statistically significant in predicting asymptomatic nephrogenic hematuria with excess syndrome(P < 0. 05). Conclusion m Alb and GLO can be used as independent predictors for the diagnosis of asymptomatic nephrogenic hematuria. Hb and LDL-C can be used as independent predictors for the diagnosis of asymptomatic nephrogenic hematuria.
引文
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[2]葛均波,徐永健.内科学[M]. 8版.北京:人民卫生出版社,2013:473-476.
[3]国家技术监督局.中医临床诊疗术语:证候部分[M].北京:中国标准出版社,1997:1-17.
[4]林燕,曹式丽.肾性血尿临床辨证及影响因素研究[J].天津中医学院学报,2005,24(1):29-30.
[5]卜先辉,王兴春,张娓娓.原发性系膜增生性肾小球肾炎补体及免疫球蛋白水平分析[J].临床误诊误治,2017,30(10):90-93.
[6]方雯.体检人群血红蛋白与血黏度的相关性分析[J].现代医学,2015,43(10):1280-1282.
[7]扎拥,庄兰萍,次仁罗布,等.高原红细胞增多症患者彩色脑血流图及全血黏度的变化[J].中华保健医学杂志,2013,15(2):167-169.
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