应用血清半胱氨酸蛋白酶抑制剂C评价肾小球滤过功能的临床研究

Clinical application of serum cystatin C to evaluate glomerular filtration rate

目的探讨血清半胱氨酸蛋白酶抑制剂C(serum cystatin C,SCysC)评价肾功能损伤不同时期肾小球滤过率(GFR)的临床应用价值。方法随机选择近2年来在我院住院的慢性肾脏病(CKD)患者146例。根据1992年中华肾脏病学会全国肾小球疾病座谈会制定的慢性肾功能衰竭(CRF)诊断标准及分期分成肾功能正常组及慢性肾功能不全代偿期、失代偿期、衰竭期、终末期。各组同时进行SCysC和血肌酐(Scr)检测,并计算出肌酐清除率(creatinine clearance,Ccr)。结果本文146例慢性肾脏病患者中,肾功能正常者Ccr正常,SCysC也正常,随着Ccr值逐渐下降,SCysC值随之上升。各组SCysC与Ccr之间均呈高度负相关关系。结论SCysC可以单独作为评价GFR的敏感指标,而且,比Ccr更客观地反映肾功能损伤不同时期GFR的功能。

Objective To discuss the clinical application of serum cystatin C （Scys C） in evaluating glomerular filtration rate （GFR） of renal function at different stages. Methods 146 hospitalized patients with chronic kidney disease （CKD） were selected in recent 2 years. Patients were divided into 5 groups：normal renal function,chronic renal failure compensatory stage,decompensatory stage, failure stage, end stage group. The Ccr and SCys C were detected in each group. Results In 146 CKD patients, Ccr and SCys C were normal when the renal function was normal. Ccr was depressed while SCys C increased. Ccr is significantly correlated reversely with SCys C in every group. Conclusions Expression of SCys C is a sensitive marker that related with GFR. More objective results for evaluated renal function can be received by SCys C than by Ccr.