胱抑素C与早期肾功能损害的关系

目的 探讨内源性标志物血清胱抑素C（cystatin C,cys C）在评价早期肾功能损害中的价值。方法 收集住院的慢性肾病患者108例，按内生肌酐清除率(Ccr)值分早期肾功能不全组、中晚期肾功能不全组，40例正常对照组取自本院体检健康人群。乳胶颗粒增强免疫透射比浊分析法( PETIA) 测定血清cys C的浓度，肌氨酸氧化酶法测定血清肌酐（Scr）浓度，酶偶联法测定尿素氮（BUN）。比较cys C、Scr、BUN与Ccr的相关性及其阳性检出率。采用似然比（LR）评价cys C的可靠性。结果 对照组、早期肾功能不全组、中晚期肾功能不全组的血清cys C分别为（0.63±0.41）、（2.59±1.32）、（7.13±1.68）mg/L。cys C、Scr 、BUN与Ccr均呈显著相关( P < 0.05)，以cys C与Ccr的相关程度最密切。血清cys C的阳性检出率最高，LR以血清cys C为最佳。结论 血清cys C是一个敏感的反映肾小球滤过功能的指标，对早期诊断肾功能损害具有重要价值。

The relationship between cystatin C and early impairment of renal function

Objective To evaluate the applicability of serum cystatin C (cys C) as a endogenous marker in the detection of early renal dysfunction. Methods Serum samples were obtained from 108 inpatients with chronic kidney disease from the No. 163 Hospital of PLA who were divided into early renal inadequacy group and advanced renal inadequacy group according to the Ccr values, Sera of 40 healthy persons from the same hospital as controls were also collected. Serum cys C concentrations were determined by particle-enhanced turbidimetric immunoassay (PETIA), Serum creatinine (Scr) was detected by Sarcosine oxidase method, and urea nitrogen (BUN) was measured by enzyme-coupled method. The correlation and positive rate between Ccr and the above three indicators were compared. The reliability of cys C was evaluated by the likelihood ratio(LR). Results Serum cys C concentrations in control group, early renal inadequacy group and advanced renal inadequacy group were 0.63±0.41, 2.59±1.32 and 7.13±1.68 mg/L, respectively. The correlations were significant between Ccr and cys C, Scr, BUN(P＜0.05), and the correlation between Ccr and cys C was the best. The positive rate of serum cys C was the highest and LR of serum cys C was the best. Conclusion Serum cys C was an sensitive indicator of GFR and was useful for the diagnosis of early renal dysfunction.