血清胱抑素C对急性肾衰竭患者的早期诊断价值

目的探讨血清胱抑素C（cystatinC）在急性肾衰竭（acuterenalfailure，ARF）患者的早期诊断价值。方法在入ICU即刻及以后每日清晨收集352例ICU患者血清，用酶法测定肌酐（serumcreatinine，Scr），用颗粒增强散射免疫比浊法测定血清cystatinC，用公式计算肾小球滤过率（glomerularfiltrationrate，GFR），按RIFLE标准把患者分为ARF组和非ARF组，对上述各指标进行比较分析。结果ARF组患者的cystatinC与Scr水平高于非ARF组（P〈0．01）；ARF组患者血清cystatinC与GFR呈负相关（r=-0．72，P〈0．01）；急性肾衰竭患者cystatinC与Scr出现异常在病程上有差别：cystatinC为（4．6±2．5）d；Ser为（5．8±3．9）d（P〈0．01）。结论ARF组患者血清cystatinC明显升高，与急性肾衰竭患者肾小球滤过率有较好的相关性，cystatinC早于Scr发现肾功能的异常，cystatinC检测可用于ICU患者并发ARF的早期诊断指标。

Diagnostic value of serum cystatin C in early acute renal failure

Objective To study the diagnostic value of serum cystatin C in acute renal failure （ARF） in ICU. Methods blood samples of 352 patients in ICU were collected. The concentration of serum creatinine and eystatin C were measured with enzymic method and particle enhanced immunonephelometry （PEINA）, respectively. Glomerular filtration rate （GFR） was estimated with MDRD. ARF was diagnosed according to RIFLE criteria. The correlation between GFR and cystatin C was analyzed. Results The level of cystatin C and Serum creatinine was significantly increased in ARF group （P〈0. 01）. The level of cystatin C in ARF inversely was correlated with GFR （r=-0. 72,P〈0.01）. The rising of cystatin C was more early than that of Scr （P〈0. 01）. Conclusion Cys-C concentration may be useful in the discriminate diagnosis of early ARF patients in ICU.