血清胱抑素C在儿童肾脏疾病中的应用研究

目的研究血清胱抑素C(CYS-C)作为肾小球滤过率的指标在儿童肾脏疾病诊断中的意义。方法以内生肌酐清除率(Ccr)对三种临床上常见的肾脏疾病患儿进行分组,测定患儿血清CYS-C浓度,并与反映肾小球滤过功能的常用指标血清肌酐(Cr)、血清尿素氮(BUN)和β2-微球蛋白(β2-MG)进行比较。结果与正常对照组比较,血清CYS-C和β2-MG浓度在Ccr>80时即有显著性差异,而血清BUN和Cr只有当Ccr<80时才具显著性差异。在肾脏疾病非肾衰期,血清CYS-C和β2-MG的异常检出率显著高于血清BUN、Cr和Ccr,但在非肾脏疾病中仅β2-MG具有较高异常检出率。结论血清CYS-C是儿童肾脏疾病及其肾小球滤过功能损害早期诊断高敏感性和特异性指标。

Application of Cystatin C in Children Kidney Diseases

Objective: To investigate significance of serum cystatin C (CYS-C)as marker of glomerular filtration rate in diagnosis of children kidney diseases.Method: Serum CYS-C concentration are assayed in children afflicted with three kinds of common kidney diseases, which are divided into groups by endogenous creatinine clearance, and compared with the frequently used markers including blood serum creatinine,blood uria nitrogen (BUN)and β_2-microglobulin (β_2-MG)that reflect glomerular filtration function.Results: Compared with the normal control group, both concentration of serum cystatin C and β_2-MG are already significantly higher when Ccr>80 , while those of serum BUN and Cr are significantly higher only when Ccr <80 . Except stage of kidney function failure among these kidney diseases groups, the abnormal detection rate of serum cystatin C and β_2-MG are significantly higher than that of serum BUN,creatinine and endogenous creatinine clearance, whereas the abnormal detection rate of serum β_2-MG is significantly higher than others in the groups without kidney diseases.Conclusion: Serum CYS-C is a high sensitive and specific marker in earlier period diagnosis of children kidney diseases and functional lesion of glomerular filtration.