目的 探讨血清中胱抑素C（Cys-C）在糖尿病、高血压为主要原发疾病的慢性肾病患者进行早期筛查和监测的临床意义。 方法 收集2007年7月－2009年3月由糖尿病、高血压引起慢性肾病患者的血清，采用微粒子增强免疫透射比浊分析法测定由89例糖尿病、76例高血压引起慢性肾病患者血清Cys-C浓度，同时测定其血清尿素氮（BUN）、肌酐（Scr）、尿白蛋白排泄率（UAER），根据UAER的量分组统计，分析血清Cys-C与其他传统肾功能指标的相关性。 结果 由于高血压、糖尿病等慢性疾病引起早期肾病时，患者血清Cys-C、UAER与正常对照组间差异有统计学意义（P＜0.01），而传统的肾功指标BUN、Scr与正常对照组差异无统计学意义（P＞0.05）,在中晚期肾病患者中Cys-C浓度与UAER 、BUN、Scr呈显著正相关（r=0.936，0.692，0.653；P＜0.01)。 结论 与BUN、Scr相比，血清Cys-C是一个更准确、更敏感反映早期肾病的指标，是糖尿病/高血压患者早期发现肾病并发症的一项重要监测指标，具有临床意义。
Objective To assess the burden of hypertensive nephropathy in China and the world from 1990 to 2021 and predict future trends. Methods Based on the Global Burden of Disease Database 2021, standardized prevalence, standardized mortality and standardized disability adjusted life year (DALY) rates were used to describe the burden of hypertensive nephropathy in China and the world from 1990 to 2021. Estimated annual percentage change (EAPC) and autoregressive integrated moving average model were used to reveal the trend of disease burden. Results From 1990 to 2021, the EAPCs of standardized prevalence, standardized mortality and standardized DALY rates of hypertensive nephropathy in China were −0.61% (−0.73%, −0.50%), −0.77% (−0.85%, −0.69%), and −1.00% (−1.09%, −0.91%), respectively. The global EAPCs for standardized prevalence, standardized mortality, and standardized DALY rates of hypertensive nephropathy were −0.16% (−0.18%, −0.13%), 0.97% (0.91%, 1.03%), and 0.63% (0.58%, 0.67%), respectively. The standardized prevalence rate, standardized mortality rate and standardized DALY rate of hypertensive nephropathy in China all showed a downward trend, and the global standardized prevalence rate also showed a downward trend, while the global standardized mortality rate and standardized DALY rate showed an upward trend, and the indicators of disease burden in China were lower than the global level. The standardized mortality rate and the standardized DALY rate of hypertensive nephropathy were higher in males than in females. With the increase of age, the disease burden indicators of hypertensive nephropathy in China and the world were on the rise, and the age of disease and death were concentrated in the age group over 65 years old. Renal dysfunction and hypertension were important risk factors for death in hypertensive nephropathy patients. It was estimated that from 2022 to 2040, the standardized prevalence rate and mortality rate of hypertensive nephropathy would be on the rise in China and the world, and the standardized DALY rate would be on the rise in the world, while in China it would be on the decline. Conclusions The burden of hypertensive nephropathy is heavy in China and the world from 1990 to 2021, and the control of hypertension and prevention of renal dysfunction should be strengthened. It is estimated that the standardized prevalence and mortality of hypertensive nephropathy will increase in China and the world from 2022 to 2040, and the disease burden will remain heavy.