血清胱抑素C评价慢性心衰患者早期肾功能损害的临床研究

目的探讨血清胱抑素C（Cystatin,Cys-C）对慢性心力衰竭（Chronic Heart Failure,CHF）患者早期肾功能损害的诊断价值。方法选择2009年2～10月在我院急诊科住院的心脏病患者62例,并将其分为A、B两组。A组31例为无原发性肾脏病变的慢性心力衰竭患者,B组31例为无心力衰竭心脏病患者,另选32例健康志愿者作为健康对照组,设为C组。分别测定A、B、C三组Cys-C、血清肌酐（SCr）、尿素氮（Bun）及血清β2-微球蛋白（β2-MG）水平,并进行统计分析。结果A组与B、C组相比,Bun、SCr、β2-MG差异无统计学意义（P〉0.05）,而A组与B、C组相比,血Cys-C差异有统计学意义（P〈0.01）。结论无原发性肾脏病变的心衰患者存在以肾小球滤过功能受损为特征的早期肾功能异常;心衰程度愈重,肾功能损伤愈明显,Cys-C检测可用于CHF患者早期肾脏损害诊断。

Sermn Cystatin C: The Sensitive Parameter in Diagnosing Chronic Heart Failue With Early Renal Impairmen

Objective To discuss the changes of the Serum Cystatin C （Cys-C） in patients with chronic heart failue and diagnosis early impairment of renal function. Methods Totally 62 patients with heart disease （Meet the inclusion criteria） from February to October 2009 in emergency department of our hospital were selected to assign into A,B groups. Group A has 31 cases of primary kidney disease-free patients with chronic heart failure and group B has 31 patients free of heart failure patients with heart disease,the group C is 32 cases of other options as a healthy control group of healthy volunteers. Serum Cystatin C ,blood creatinine,urea nitrogen and β2-MG were measured in 31 patients with CHF,31 patients with cardiovascular diseases but compensated heart function and 32 normal volunteers. Results The group A Bun,SCr,β2-MG as compared with group B and C was no significant difference （P〉0.05）. The group A Cys-C as compared with group B and C was statistically significant （P〈0.01）. Conclusion There is early abnormality of renal function in CHF patient s without primary renal disorder and the abnormality was featured by impaired glomorular filtration function. The more severe the heart failure,the more significant the renal function impairment. Cys-C was a marker of early impairment of renal function in chronic heart failure.