血清视黄醇结合蛋白与半胱氨酸蛋白酶抑制剂C对肾脏疾病的诊断价值

目的：探讨血清视黄醇结合蛋白（retinal—binding protein，RBP）与半胱氨酸蛋白酶抑制剂C（cysteine protein—ase inhibitorC，CysC）在肾脏疾病中的诊断价值。方法：选取165例肾脏疾病患者和177例健康对照者，分别检测并比较两者血清中RBP，CysC，血肌酐和尿肌酐水平以及肌酐清除率（ereatinine clearancerate，Ccr）；对血清中RBP的含量与CysC、肌酐、Ccr等指标的含量作相关性分析；作RBP、CysC与肌酐对肾脏疾病诊断的ROC曲线，计算ROC曲线下面积。结果：与健康对照组相比，患者组血清RBP、CysC和肌酐水平显著增高，而Ccr水平明显降低（P均〈0．0001）；患者组血清中RBP与CysC、肌酐呈明显正相关，与Ccr呈明显负相关（r分别为0．726，0．705，-0．803，P均〈0．01）。RBP、CysC、肌酐对肾脏疾病的ROC曲线下面积分别为0．856，0．917，0．810；敏感度分别为81．2％，91．5％，63．3％；特异度分别为73．2％，78．2％，95．2％。结论：血清RBP和CysC对肾脏疾病均有一定的诊断价值，但RBP低于CysC。

Diagnosis value of serum retinal-binding protein and cysteine proteinase inhibitor C in renal diseases

Objective： To evaluate the value of serum retinal-binding protein（RBP） and cysteine proteinase inhibitor C（Cys C） in the diagnosis of renal diseases. Methods： A total of 165 patients with renal disease （patient group） and 177 healthy subjects （control group ） were enrolled in the study. Serum RBP, Cys C, creatinine（Cr） and urine Cr were assayed and compared; creatinine clearance rate（Ccr） of the two groups were calculated and compared. Correlation between serum RBP with Cys C, creatinine （Cr） and Ccr were analyzed. ROC curve for the diagnosis of renal disease were drawn and the area under ROC curve was calculated. Results： Compared with the control group, the serum levels of RBP, Cys C and Cr in patient group were higher, but Ccr was lower; Serum levels of RBP in patient group was positively correlated to Cr, while Cys C levels negatively correlated to Ccr （r = 0. 726, 0. 705, - 0. 803, both P 〈 0.01 ）. The area under the ROC curve of RBP, Cys C and Cr were 0. 856, 0. 917 and 0. 810, respectively; the diagnosis sensitivity were 81.2%, 91.5% and 63.3% ; and the diagnosis specificity were 73.2% ,78.2% and 95.2%. Conclusion： The value of serum levels of RBP in the diagnosis of renal disease was lower than that of Cys C.