半胱氨酸蛋白酶抑制剂C与肾移植后尿路梗阻患者的肾功能

背景：半胱氨酸蛋白酶抑制剂C不被肾小管分泌和重吸收，近年来被认为是一种非常理想的评价肾小球滤过率的指标。目的：探讨肾移植后输尿管狭窄患者血清半胱氨酸蛋白酶抑制剂C水平变化及其在肾功能损伤诊断中的价值。方法：选取2007年4月至2011年4月于深圳市第二人民医院泌尿外科及广州华侨医院泌尿外科行肾移植并于移植后发生输尿管狭窄伴肾功能不全的患者18例作为病例组，同时纳入同期年龄性别与病例组相匹配的健康体检者63名作为对照组。分别于输尿管狭窄治疗前及治疗后1个月测定患者血清半胱氨酸蛋白酶抑制剂C、肌酐、尿素氮水平并分析其相关性。结果与结论：与对照组比较，病例组输尿管狭窄治疗前半胱氨酸蛋白酶抑制剂C、血肌酐和尿素氮水平均显著增高（P〈0．01）；治疗后1个月，病例组半胱氨酸蛋白酶抑制剂C、血肌酐和尿素氮水平较治疗前显著降低（P〈0．01）。相关分析结果显示，肾移植后输尿管狭窄患者血清半胱氨酸蛋白酶抑制剂C水平与血肌酐和尿素氮水平呈正相关。提示血清半胱氨酸蛋白酶抑制剂C可作为肾移植后。肾功能恢复情况的监测指标。

Serum cystatin C is considered to monitor the renal function of urinary tract obstruction patients after renal transplantation

BACKGROUND： As cystatin C cannot be secreted and reabsorbed by the renal tubule, it is considered as an ideal indicator to evaluate the glomerular filtration rate in recent years. OBJECTIVE： To assess the change of serum cystatin C level in ureteral stenosis patients after renal transplantation and to investigate the effect on the diagnosis of renal function impairment. METHODS： Eighteen renal transplantation patients with ureteral stenosis and renal insufficiency after renal transplantation were selected from the Department of Urology, Shenzhen Second People＇s Hospital and Guangzhou Overseas Chinese Hospital as the case group, while there were 63 healthy cases in the control group whose age and gender were matched with those in the case group. The levels of serum cystatin C, serum creatinine and urea nitrogen were tested before and at 1 month after the treatment of ureteral stenosis, and the correlation was analyzed. RESULTS AND CONCLUSION： Compared with the control group, the levels of serum cystatin C, serum creatinine and urea nitrogen in the case group were increased significantly before the treatment of ureteral stenosis （P 〈 0.01）; at 1 month after treatment, the levels of serum cystatin C, serum creatinine and urea nitrogen in the case group were decreased significantly when compared with those before treatment （P 〈 0.01 ）. The relative analysis results showed that the serum cystatin C level of the ureteral stenosis patients was positively correlated with the levels of serum creatinine and urea nitrogen. It suggests that serum cystatin C can be regarded as one of the monitoring indicators of renal function recovery after renal transplantation. Key Words： organ transplantation; renal transplantation; renal insufficiency; cystatin C; ureteral stenosis; urinary tract obstruction; diagnosis; creatinine; urea nitrogen