血清胱蛋白酶抑制剂C在慢性阻塞性肺疾病早期肾功能损害诊断中的价值

目的 探讨慢性阻塞性肺疾病（COPD）患者早期肾功能损害敏感指标血清胱蛋白酶抑制剂C（Cystatin C）的水平及尿系列酶活性的相关变化.方法 选择COPD稳定期患者70例和健康对照组30例,采用酶联免疫法测定受试者血清Cystatin C水平;采用底物速率法检测尿系列酶N-乙酰-β-D氨基葡萄糖苷酶（NAG）、β-乳糖苷酶（GAL）、γ-谷氨酰转移酶（GGT）和碱性磷酸酶（ALP）的活性.结果 与对照组相比较,COPD患者血清Cystatin C水平和尿系列酶活性均显著增高（P＜0.05）,而常规肾功能指标无显著性差异（P＞0.05）.COPD患者血清Cystatin C水平与FEV1预计值呈负相关（P＜0.05）;NAG和ALP与FEV.呈负相关（P＜0.05）.结论 COPD患者血清Cystatin C水平及尿系列酶活性显著升高,提示COPD患者存在肾功能损害.血清Cystatin C水平及尿系列酶活性是临测COPD患者早期肾功能损害的敏感指标.

Diagnostic values of serum Cystatin C in early renal damage of chronic obstructive pulmonary diseases

Objective To study the diagnostic values of serum cystatin C and serial urinary enzymes in early renal damage of chronic obstructive pulmonary diseases （COPD）. Methods A total of 70 COPD patients in stable period and 30 normal controls （ control group） were selected. The level of serum cystatin C was detected by ELISA, and serial urinary enzymes [ N-acetylglueosaminidase（ NAG）, galaetosidae （ GAL）, γ-glutamyltransferase （ GGT）, alkaline phosphatase （ALP） ] were detected by rate assay. Restilts The level of serum Cystatin C in COPD group higher than that in control group （ P 〈 0.05 ）. In patients with COPD ,the levels of NAG and ALP were significantly higher than those in control group（ P 〈 0.05 ）. There was no difference in conventional renal functions between COPD group and control group（ P 〉 0.05）. In patients with COPD, the level of serum Cystatin C was negatively correlated with predicted value FEV1% （ P 〈 0.05 ） ; the level of NAG and ALP were negatively correlated with predicted value FEV1% （P 〈 0.05 ）. Conclusion The levels of serum cystatin C and serial urinary enzymes in COPD patients are increased in patients with renal function is impaired. They may be used as sensitive indicators for monitoring early renal damage in patients with COPD.