测定血清胱抑素C在肾脏疾病中的诊断价值

Value of Detecting Serum Cystatin C in Diagnosis of Kidney Disease

目的探讨血清胱抑素C(Cystatin C,Cys C)在肾功能损害及损伤时作为敏感标志物对临床诊断的价值。方法对63例患者采用免疫比浊法测定血清胱抑素C的浓度,同时测定肌酐(Scr)、尿素氮(BUN),根据cockcroft.Gault公式计算内生肌酐清除率(Ccr)。结果随着Ccr下降血清Cys C、BUN、Scr均值逐渐升高(P<0.05)。Ⅰ组18例患者血清中Cys C浓度异常者占56%,Scr的浓度异常者占22%;Ⅱ组26例患者血清中Cys C浓度异常者占77%,Scr的浓度异常者占31%;Ⅲ组19例患者血清中Cys C、Scr浓度异常者均占100%。结论血清胱抑素C是反映肾脏损伤的敏感指标,比BUN、Scr更能准确直观的反映出肾小球滤过功能,测定方法简便,可以替代操作繁琐的内生肌酐清除率来判断肾小球滤过功能。

Objective To discuss the value of serum Cystatin C as a sensitive mark in the clinical diagnosis of renal dysfunction and injury. Methods The serum levels of Cys C,Creatinin（Scr） and blood urea nitrogen（BUN） of 63 patients were detected by the immune turbidimetry and enzyme methods. The creantinine clearance（Ccr） was calculated by using Cockcroft-Gauh formula. Results The mean levels of Cys C, Scr and BUN increased with the decrease of Ccr（ P 〈 0.05 ）. The ratio of patients with abnormal Cys C and Scr were 56% and 22% in group I （n = 18） ,//% and 31% in group 1] （n =26） and 100% and 100% in group m （n = 19 ） , respectively. Conclusion Serum Cys C is a sensitive mark of renal injury. It can be detected easily and effectively used to evaluate the glomerular filtration function as compared with the endogenous creatinine clearane（Ccr） method.