早期肾小管损伤标记物尿Cystatin C的临床应用前景与亟待解决的问题

Prospects for clinical applications of Cystatin C as a marker of early renal tubular injury and the current problems

肾小管标记物对早期诊断肾小管间质损伤有重要意义,尿Cystatin C能灵敏反映早期肾小管损伤。近年开发的免疫浊度法已能应用于自动分析仪,因而能用于日常临床检验工作。尿Cystatin C检测可应用于糖尿病肾病、高血压肾病、药物毒性肾损伤的早期诊断。由于各种慢性肾疾病发病率的增高,肾小管标记物的临床应用也将不断增加。当前的问题是检测方法的标准化,并按循证检验医学的要求进行进一步论证,在临床检验中可采用一次尿作样品,用尿肌酐比值来报告。

The renal tubular markers are very important for early diagnosis of renal tubulointerstitial injuries. Urinary excretion of Cystatin C is a sensitive marker of early injury in renal proximal tubule. The particle turbidimetric immunoassay developed in recent years has been used in the autoanalyzer, and may be used in medical laboratories routinely. Urinary cystatin C excretion has early diagnostic value for diabetic nephropathy, hypertensive nephropathy, and drug-induced renal impairments. This tubular marker will be used more frequently for the diagnostic purpose, as the trend of various chronic kidney diseases will be increased in the near future. The current problems to be solved are the standardization of methodology, and the further study according to the guidelines of evidence-based laboratory medicine. In the routine testing, the ratio of a spot urine Cystatin C concentration to creatinine is recommended.