血清半胱氨酸蛋白酶抑制剂C早期诊断过敏性紫癜患者肾功能损伤的临床研究

目的探讨检测血清Cystatin C对早期发现过敏性紫癜患者肾功能损害的意义。方法测定83例过敏性紫癜患者的24h肌酐清除率(24h CCr),血清肌酐(SCr)以及血清Cystatin C(Cys C)水平,并以CCr﹤80ml/min/1.73m2作为肾功能损害诊断标准,采用χ2检验、相关性分析和ROC曲线分析CysC的诊断价值。结果 83例患者中共32例出现CCr下降,其中Cys C水平上升有27例,而仅有13例SCr出现异常。Cys C对CCr的评估效能优于SCr(P﹤0.05),相关性分析提示在过敏性紫癜患者中,Cys C与SCr和CCr均有显著负相关性(Cys C:r=-0.823,P﹤0.001;SCr:r=-0.563,P﹤0.001)。ROC曲线分析显示Cys C的曲线下面积(AUC)值明显高于SCr(0.863vs0.601)。结论 Cys C较SCr能更为准确和迅速地反映过敏性紫癜患者的肾功能损害;常规监测该类患者的Cys C水平,对有效防治过敏性紫癜导致的肾功能损伤具有积极意义。

Diagnostic value of serum cystatin C for detection of renal injury early in patient with Henoch-Schonlein purpura

OBJECTIVE To investigate the diagnostic value of serum Cystatin C for detection of renal injury early in patient with henoch-schonlein purpura.METHODS 24 hours Creatinine Clearance(CCr),serum level of Cystatin C(Cys C)and serum Creatinine were measured in 83 patients with henoch-schonlein purpura(HSP).χ2 test,Pearson correlation test as well as ROC curve were utilized to evaluate the diagnostic significance of Cys C.RESULTS Thirty-two of 83 HSP patients showed the renal injury.Among these 32 patients,27 cases’ Cys C had elevated,whereas 13 cases’ SCr had a abnormity.Cys C and SCr were inversely correlated with CCr(CysC:r =-0.823,P﹤0.001;SCr:r =-0.563,P﹤0.001).However,coefficient of Cyst C to CCr was obviously higher than that of SCr.Moreover,using ROC curve,Cystatin C was diagnostically superior to SCr(area under the curveAUC]for Cyst C 0.863;AUC for SCr 0.601).CONCLUSION Cystatin C is a more accurate and sensitive marker of renal injury in HSP patients.Detection of Cys C level in HSP patients could contribute to the treatments of HSP.