慢性肾脏病患者血浆半胱氨酸蛋白酶抑制剂C检测的临床意义

目的:探讨血浆半胱氨酸蛋白酶抑制剂C(Cystatin C)水平的检测在慢性肾脏病(CKD)患者中的临床意义。方法:研究对象为10名健康人(对照组)和42例CKD患者,检测其血清CystatinC、血肌酐(Scr)水平及肌酐清除率(Ccr)。以~(99m)Tc-DTPA清除率测得的肾小球滤过率(GFR)为标准,比较Cystatin C,Scr,与Ccr的相关性及CysC与Scr敏感度。结果:18例CDK 1期患者,其BUN、Scr与对照组比较无显著性差异(P>0.05);血Cys、β_2-MG、24 h尿蛋白、尿Cys浓度与对照组比较存在显著性差异(P<0.01);CysC与Ccr相关性系数r为-0.45,P<0.05,而SCr与Ccr无显著相关性(P>0.05),24例CKD 2、3、4、5期患者Cys C,Scr与Ccr都成显著负相关性(P<0.01),相关系数r分别为-0.88、-0.75;CKD 1期、2期患者CysC阳性数与SCr阳性数两者比较存在显著性差异(P<0.01),CKD 3、4、5期患者CysC阳性数与Scr阳性数比较均无显著性差异(P>0.05)。结论:血清Cystatin C是理想的反映GFR的血清标志物,对慢性肾脏(CKD)患者诊断有极其重要的临床意义。

Value of Application of Serum Cystatin C for Diagnosing in Chronic Renal Patients

Objective To explore value of the applicability of Cystatin C for diagnosing in chronic kidney disease (CDK) patient.Methods Cystatin C,serun creatinine (Se r),ereatinine clearance rate (Cer)were measured in 10 cases of healthy person and 42 cases of CKD patients.Glomerular filtration rate(GFR) by ~(99m)Tc-DTPA clearance rate was considered to be a gold standard,the correlation and the abnormal rate between Cystatin C and the above two parameters were compared.Rosults There was no Statistically different between 18 eases of C KD I patients and healthy person for BUN and Scr(P>0.05),but it was statistically different among those groups for serum eystatin C,β_2-MG,urine protein of 24 h and urine eystatin C(P<0. 01);Correlation coefficients with Ccr were -0.45 for serum eystafin C(P<0.05),comparision were non-correlation coeffi- cients detween Set and Cer(P>0.05),negative-Correlation coefficients with Ccr were—0.88 for serum cystatin C,-0. 75 for SCr(P<0.01),with regard to 24 eases of CKDⅡ-Ⅴpatients,statistically different between the positive number of CysC and the positive number of SCr for CKDⅠand CKDⅡpatients(P<0.01).howover,the patients of CKDⅢ、ⅣandⅤwere contrasted(P>0.05).Oonclusion Serum e ystatin C is a more sensitive and specific maker for GFR.