血清胱抑素C测定在糖尿病及高血压肾病早期诊断的临床意义

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。

Clinical Significance of Serum Cystatin C Determination in the Early Diagnosis of Diabetic and Hypertensive Nephropathy

Objective To investigate the clinical significance of serum cystatin C(Cys-C) determination in early screening and monitoring primary chronic kidney diseases(CKD) induced by hypertension and diabetes.Methods We collected the serum of 89 patients with diabetes-induced and 76 patients with hypertension induced CKDs treated between July 2007 and March 2009.The concentrations of Cys-C,blood urea nitrogen(BUN),serum creatinine(Scr),and urinary albumin excretion rate(UAER) in the patients were detected by particle enhanced turbidimetric immunoassay.Then,based on UAER,we analyzed the relationship between Cys-C and traditional parameters in renal function injury.Results The concentrations of serum Cys-C and UAER in early nephropathy patients were significantly different from the normal controls(P<0.01),while there was no statistical difference in traditional parameters like BUN and Scr(P>0.05).For patients with intermediate or advanced renal injury,the concentration of serum Cys-C was significantly correlated with UAER,BUN and Scr(r=0.936,0.692,0.653,P<0.01).Conclusion Compared with BUN and Scr,serum Cys-C is a more accurate and sensitive parameter in reflecting early nephropathy,and it is of important clinical value in monitoring the complications of the diabetic or hypertensive nephropathy.