胱抑素与老年肌酐正常肾损害患者肾小球滤过率的相关性研究

目的探讨在血清肌酐正常的老年肾损害患者中,胱抑素(cystatinC,Cys-C)对肾小球滤过率(GFR)评价的意义。方法对2002-11~2003-12泸州医学院附属医院86例有肾损害但血清肌酐(Scr)正常的老年患者,应用乳胶颗粒增强比浊法测定血清中Cys-C浓度,并采用CockCroft-Cault公式计算内生肌酐清除率(Ccr)。分别比较Cys-C与Scr和Ccr的相关性。结果56例Cys-C升高超过正常,占56.1%;比较Ccr≤59mL/min和Ccr>59mL/min两组间的Cys-C质量浓度发现,当Ccr≤50mL/min时,97.1%的患者Cys-C超过正常,在Ccr>59mL/min时,已有44.2%患者Cys-C超过正常。血清Cys-C与Scr存在高度的正直线相关(r=0.89,P<0.01);Cys-C与Ccr存在高度的负直线相关(r=-0.87,P<0.01)。结论在老年患者中,Cys-C比Scr和Ccr更敏感地反映早期肾小球滤过率的下降。

The relationship between cystatin C and glomerular filtration rate in creatinine-blind range elder patients

Objective To explore the relationship bewteen serum cystatin C (Cys-C )and glomerular filtration rate(GFR) in creatinine-blind range elderly patients. Methods From Jan.2002 to Dec.2003,in the Affiliated Hospital of Luzhou Medical College,the study was performed in 86 elderly patients with chronic renal disease.Serum Cys-C was determined by particle-enhanced immunoturbidimetry.Serum creatinine(Scr) was determined by auto-analyzer.Creatinine clearance rate(Ccr) was estimated by CockCroft-Cault formula.For statistical evaluation,linear regression analysis was used. Results Concentration of Cys-C increased in 56 patients(56.1%).When Ccr was higher than 59mL/min,concentration of Cys-C increased in 44.2% patients.Significant positive correlation was observed between Cys-C and Scr( r =0.89, P <0.01).Cys-C was negatively correlated with Ccr( r =-0.87, P <0.01). Conclusion Cys-C is a more sensitive parameter than Scr and Ccr for early stage reduced GFR.