摘要
目的探讨Cystatin C在评估慢性肾功能衰竭透析患者残余肾功能(RRF)中的应用价值,寻找一种对透析患者较简便、精确的RRF估算指标。方法收集95例透析患者(其中血液透析患者61例,腹膜透析患者34例)的血、尿标本分别测定血肌酐(Scr)和尿肌酐(Ucr)以及Cystatin C浓度,分析血清Cystatin C能否很好地估算透析患者的RRF,并且将它估算的RRF(eGFR1)同标准的RRF以及肾脏病膳食改良试验(MDRD)公式得出的RRF(eG-FR2)进行比较。结果所有透析患者Cystatin C和Scr浓度均伴随着RRF的降低而上升,但Cystatin C的上升幅度比Scr平稳。血液透析及腹膜透析患者Cystatin C、Scr与RRF均呈负相关(r=-0.53、r=-0.46,P<0.05;r=-0.71r、=-0.63,P<0.05)。血液透析及腹膜透析患者分别基于Cystatin C和Scr测得eGFR与RRF均呈正相关(r=0.69、r=0.63,P<0.05;r=0.74、r=0.58,P<0.05),且Cystatin C测得eGFR与RRF的相关性更好。结论Cystatin C估算透析患者RRF准确、简便,在24 h尿标本难于准确收集的情况下,Cystatin C比Scr更适合透析患者RRF的估算。
Objective To exlpore whether Cystatin C assay could be applied to assessing the residual glomerular filtration rate （RRF） in chronic renal failure dialysis patients. Methods Plasma and urine samples from 61 Hemodialysis and 34 peritoneal dialysis patients were subjected to assay of serum creatinine （Scr）, urine creatinine （Ucr） and Cystatin C level respectively. A comparison was made between the RRF （eGFR1） derived from the assay of Cystatin C levels and the RRF （eGFR2） derived from the standard RRF or the Modification of Diet in Renal Disease（MDRD） calculation formula. Results Cystatin C and Scr levels rised in all the dialysis patients with RRF descending,but the rise of Cystatin C levels was milder than that of Scr. The levels of Cystatin C and Scr in both hemodialysis and peritoneal dialysis patients were negatively correlated with RRF （r=-0.53,r=-0.46,P〈0.05;r=-0.71,r=-0.63,P〈0.05）. The eGFR derived from Cystatin C and Scr formula was positively correlated with RRF（r=0.69 ,r=0.63 ,P〈0. 05 ;r=0.74, r=0.58,P〈0.05）. And the eGFR derived from Cystatin C was correlated with RRF better. Conclusion It is accurate and precise to assess dialysis patients＇ RRF by assaying Cystatin C,and the Cystatin C assay is more suitable for assessment of RRF than Scr assay for dialysis patients when no 24 h urine sample is available.
出处
《江西医学院学报》
CAS
2009年第6期52-55,58,共5页
Acta Academiae Medicinae Jiangxi
关键词
CYSTATIN
C
血液透析
腹膜透析
残余肾功能
Cystatin C
haemodialysis
peritoneal dialysis
residual glomerular filtration rate
