胱抑素C在评估慢性心力衰竭患者肾功能不全中的价值

目的观察慢性心力衰竭（CHF）患者的血清胱抑素C（Cys-C）、血清肌酐（Scr）、肾小球率过滤（eGFR）水平,评估Cys-C在CHF患者肾功能不全中的诊断价值。方法选取我院住院88例CHF的患者测定Cys-C、Scr,计算eGRF（简化MDRD公式）,根据eGFR水平将患者分成4组：GRF正常组、GRF轻度下降组、GRF中度下降组、GRF重度下降及肾衰竭组,比较4组间Cys-C、Scr的差异并进行Cys-C、Scr与GRF的相关性分析。结果 4组患者的血清Cys-C水平分别为（0.93±0.18）,（1.08±0.22）,（1.58±0.59）,（2.7±0.86）mg/L,差异有显著统计学意义（P〈0.01）,血清Cys-C与GRF显著相关,相关系数为0.62（P〈0.01）。结论 Cys-C可以作为肾小球滤过率的判断指标,有助于慢性心力衰竭患者肾功能不全的早期诊断。

Evaluation of Renal Disfunction in Chronic Heart Failure with Cystatin C

Objective To investigate the levels of the cystatin C(Cys-C),serum creatinine(SCr)and glomerular filtration rate(GFR) in patients with chronic heart failure(CHF) and evaluate the diagnostic efficiency of cystatin C in CHF with renal disfunction.Methods 88 patients with CHF in our hospital were enrolled,Cys-C and SCr were determined,GRF was calculated by MRDR formula.According to GRF all the patients were divided into four groups:the normal renal function group(GFR≥90),the mild renal function damage group(60~89),the moderate renal damage group(30~59)、the renal dysfunction group(<30)ml/min/1.73m2,compare the difference of Cys-C,SCr in 4 groups and the relationship of Cys,SCr with GFR.Results 4 groups′ Cys-C is 0.93±0.18,1.08±0.22,1.58±0.59,2.7±0.86 mg/L separately,The difference among the groups was significant(P<0.01),the Cys-C significant correlation with the GFR(P<0.01).Conclusion Cys-C can be used as a marker in valuation of GFR.It is helpful for early diagnosis of CHF with renal disfunction.