唾液尿素、肌酐、尿酸水平在慢性肾病患者中的临床意义

摘要

目的:探讨健康人群和慢性肾病(CKD)患者唾液中尿素(Urea)、肌酐(Cr)、尿酸(UA)水平的变化和临床意义,为肾脏疾病的诊断、治疗提供一种无创、快捷、准确、可靠的检测方法.方法:收集健康人群和肾功能不全患者的唾液和血清,用全自动生化分析仪分别检测血清和唾液Urea,Cr,UA含量,计算血清与唾液Urea,Cr,UA的相关系数,比较不同时期CKD患者唾液Urea,Cr,UA浓度的变化,用ROC曲线分析唾液Urea,Cr,UA在诊断不同时期CKD患者时的灵敏度和特异度.结果:健康人群和CKD组血清与唾液Urea,Cr,UA含量均呈正相关(r分别为0.918,0.932,0.840和0.984,0.971,0.920)；CKD患者唾液Urea,Cr,UA显著高于健康人群组(P＜0.05)；中晚期CKD患者唾液Urea,Cr,UA均明显高于健康人群组和早期CKD组(P＜0.05)；晚期CKD患者唾液Urea,Cr,UA明显高于中期CKD患者组(P＜0.05)；唾液Urea,Cr,UA对整体CKD患者的诊断曲线下面积分别为0.898,0.897,0.848,ROC曲线显示其灵敏度和特异性分别为0.806,0.776,0.704和0.968,0.989,0.871.结论:健康人群和CKD患者唾液与血清中Urea,Cr,UA浓度均有良好的相关性,唾液Urea,Cr,UA浓度能反映CKD患者的肾功能损害程度,可以用来检测CKD患者的肾功能情况,并可用于中晚期CKD病人的诊断,是一种简便、无创、快捷的检测方法.%Objective: To explore the changes and clinical significance of saliva urea, creatinine (Cr), uric acid (UA) in both healthy people and chronic kidney disease (CKD) patients, and to provide a noninvasive, quick, accurate and reliable test to diagnose kindey disease.Methods: Urea, Cr and UA in the saliva and serum collected from both healthy people and the CKD patients were measured by biochemical analyzer. We calculated the correlation coefficient of Urea, Cr and UA between the saliva and serum, compared the levels of saliva Urea, Cr and UA among CKD patients in different periods, drew the receiver operation characteristic (ROC) curve and analyzed the sensitivity and specificity of saliva Urea, Cr and UA to predict CKD patients in various periods. Results: The concentrations of Urea, Cr and UA in both the saliva and the serum were positively correlated in healthy individuals and CKD patients (r = 0.918, 0.932,0.840 and 0.984,0.971,0.920). The levels of saliva Urea, Cr and UA in the CKD patients were significanly higher than those of healthy people (P<0.05). Saliva Urea, Cr and UA concentrations of middle and late stage CKD patients were obviously higher than those of healthy people and early stage CKD patients (P<0.05). Areas under the curve (AUC) of the ROC of Urea, Cr and UA to diagnose diverse periods of CKD were 0.898, 0.897 and 0.848. The sensitivity was 0.806, 0.776 and 0.704; and the specificity was 0.968, 0.989 and 0.871.Conclusion: The levels of Urea, Cr and UA between the saliva and the serum are closely related. The concentration of saliva Urea, Cr and UA can reflect the renal damage, monitor kidney function of the CKD patients, and help diagnose middle to late stage CKD patients. It is a simple, nonivasive and quick method.