血清半胱氨酸蛋白酶抑制剂C在慢性肾脏病肾功能中的应用

目的以放射性核素99Tcm-DTPA清除率测定的肾小球滤过率为标准,比较血清胱抑素C和肌酐评价GFR的准确性和特异性。方法以99Tcm-DTPA清除率法测定38例慢性肾脏病患者GFR,并同时测定Scr浓度和Cys-C浓度。运用ROC分析曲线分析SCysC和Scr评价GFR的准确性、敏感性和特异性。结果 38例慢性肾脏病患者SCys-C浓度为(1.67±0.25)mg/L,Scr浓度为(198.77±98.01)μmol/L,GFR为(50.55±35.62)mL/(min.1.73m2)。SCys-C与Scr、GFR呈明显负相关,相关系数分别为-0.74和-0.6(1P<0.05);分别以GFR<90mL(/min.1.73m2)、GFR<60mL(/min.1.73m2)和GFR<30mL/(min.1.73m2)为界点,Cys-C的Roc曲线下面积(AUC)分别为0.822、0.857、0.920;Scr的Roc曲线下面积分别为0.775、0.801和0.922。结论在慢性肾病患者中与Scr比较,Cys-C是评价GFR的一个良好内源性指标,且能更好地反映GFR的早期改变。

Application of serum cystatin-C for renal function in chronic kidney disease

Objective To compare of the serum Cystatin-C and serum creatinine with Glomerularflltrationrate measured by clearance of 99 Tc m-DTPA.Methods The Glomerularflltrationrate was measured by clearance of 99 Tc m-DTPA and the serum Cystatin-C and serum creatinine(Scr) were also measured in 38 patients with chronic kidney disease.Accuracy,sensitivity and specificity of serum Cystatin-C for renal function were evaluated by receiver operating characteristic curve(Roc curve).Results The mean values in serum CysC、Scr and GFR in 38 patients were(1.67±0.25)mg/L,(198.77±98.01)μmol/L and(50.55±35.62)mL/(min.1.73 m2).There were negative correlations between CysC、Scr and GFR.The correlation coefficients were-0.74 and-0.61.Cys-C of the Roc area under the curve(AUC) were 0.822,0.857,0.920;Scr area under the Roc curves were 0.775,0.801 and 0.922 at the boundary points of GFR < 90 mL/(min.1.73 m2),GFR < 60 mL/(min.1.73 m2) and GFR < 30 mL/(min.1.73 m2) respectively.Conclusion Compared with serum creatinine,the serum Cystatin-C is a good endogenous targets evaluation of GFR,and can better reflect the early changes in GFR.