血清胱抑素C在MDR-TB患者化疗中的临床应用

目的探讨血清胱抑素c（CysC）在耐多药结核（MDR—TB）患者化学治疗中的临床应用。方法对MDR—TB患者按照化疗时间不同分7组检测血清CysC，来判断患者化疗过程中氨基糖甙类注射剂及高尿酸血症对患者肾功能损伤情况，同时将7个组的血清肌酐（Scr）、尿素（Urea）、尿酸（UA）的浓度作为观察指标来测定。结果七组的血清CysC、Scr、UA的差异有显著性意义（P〈0．05），血清Urea的差异无显著性意义（P〉0．05），但与治疗前组相比血清CysC的浓度的变化较Scr的浓度变化出现早；在MDR-TB患者化疗过程中血清SCr、Urea无一例异常，血清uA在治疗不同时期大多数患者间或或者持续升高，血清CysC有两例在治疗2个月后出现异常，经调减注射剂剂量后恢复正常。结论血清CysC是监测MDR-TB患者化疗过程中早期肾功能损伤更敏感的指标。

Clinical application of serum cystatin C in the chemotherapy of patients with MDR-TB

Objective To explore the clinical application of serum cystatin C （CysC） in the chemotherapy of patients with multi- drug-resistant tuberculosis （MDR-TB）. Methods The patients with MDR-TB were divided into 7 groups according to the chemotherapy time, and the serum cystatin C was detected in order to judge the damage of renal function cuased by the aminoglycoside injection and hy- peruricemia. At the same time, the levels of serum creatinine （Scr）, urea （Urea） , and uric acid （UA） were measured as observed indi- cators. Results There was significant difference among the levels of serum cystatin C, Scr and UA among the 7 groups （ P 〈 O. 05 ）, but the difference of serum Urea showed no statistical significance among the 7 gronps （P 〉0. 05 ）. During the chemotherapy, the concentra- tion changed earlier in serum CysC than in serum Scr, and all of the patients＇ serum SCr and Urea was at a normal level and most patients＇ serum UA rose. The serum CysC of 2 patients began abnormal 2 months after the treatment, and was back to normal through reducing the injected dose. Conclusion Serum CysC is a more sensitive indicator than serum SCr and Urea in monitoring the early damage of renal function damage in patients with MDR-TB, and serum UA only show asymptomatic hyperuricemia during chemotherapy.