胱抑素C、尿微量蛋白、肌酐和尿素联合检测在肾病中的应用

目的探讨血清胱抑素C（cystatin C，Cys C）、尿微量蛋白、肌酐和尿素联合检测肾脏损害的临床诊断价值。方法血清胱抑素C采用免疫比浊法分析，对30名健康对照者和33名不同病程的肾功能损害者进行尿微量白蛋白（mAlb）检测分析，Jaffe速率法测肌酐（SCR），紫外速率比色法测定尿素（BUN）。结果观察组血清胱抑素C、尿微量蛋白测定结果明显高于健康对照组，其差异有统计学意义（P〈0．01）。血尿素（UREA）、血肌酐（Cr）在早期临床无症状组的比较中，无统计学意义（P〉0．5），单项检测时阳性率较低，联合检测时阳性率可明显提高，达87．31％。结论尿蛋白定性阴性不能排除肾脏的早期损伤。血清胱抑素C、尿微量蛋白与尿酶联合检测是诊断肾脏早期损伤的灵敏可靠的实验室指标，在肾脏损伤程度的分析中有重要意义。

Application of serum cystatin C,urinary microprotein,CR and UREA in nephropathy disease

Objective To study the clinical value of serum eystatin C （Cys C） , urinary microprotein, SCR and BUN in diagnosis and monitoring in the degree of kidney damaged. Methods Serum Cys C was determined by partical - enhanced turbidimetric immunoassay. 30 cases of health control and 33 cases of nephropathies patients in different progress of the disease were selected. Urinary microalbnmin （mAlb） was measured with immunoturbidimetry and urinary creatinine was determined with Jaffe rate. Results The levels of Cys C,urinary mAlb in the group of early nephropathy without clinical symptom were higher than health control group, and the differences had statistic significance （ P 〈0. 01 ）. The levels of Ccf were higher than health control group,hut no statistical significance（P 〉0. 5）. Positive rate of determining one of the several items were lower than that（ 87.31% ） of determining the several items together. There was a positive correlation between serum Cys C, urinary mAlb, Cr and the degree of nephropathy. Conclusion The negative result of qualitative urine protein can not exclude early damaged of nephropathy. It is more sensitive and reliable to union detection of serum Cys C, urine microprotein and urine enzyme for early discovery and diagnosis nephropathy. It is important for analysis the degree of nephropathy.