指甲肌酐含量与急、慢性肾功能衰竭

Content of creatine in fingernail and acute and chronic renal failure

目的观察正常人、急性肾功能衰竭（ＡＲＦ）及慢性肾功能衰竭（ＣＲＦ）病人指甲肌酐含量，分析指甲游离端肌酐含量与血肌酐含量的关系，对急、慢性肾功能衰竭进行鉴别诊断。方法剪取双手１０指指甲游离端１～２ｍｍ，制备指甲肌酐浸出液。用碱性苦味酸法测定３０例健康人、１０例急性肾衰病人、２５例慢性肾衰病人指甲肌酐含量，分别进行差异性比较。结果健康组、ＡＲＦ组及ＣＲＦ组指甲肌酐含量分别为８７．６９±２８．５６、８８．２０±２１．７４、１２６．０４±３０．６７μｍｏｌ／１００ｇ指甲。结果显示：ＡＲＦ组与健康组差异无显著性（Ｐ＞０．０５）；ＣＲＦ组和ＡＲＦ组与健康组差异有显著性（Ｐ＜０．００１），且ＡＲＦ和ＣＲＦ组病人四个月前血肌酐（ＳＣｒ）含量差异有显著性（Ｐ＜０．０１）；剪指甲时的ＳＣｒ含量差异无显著性（Ｐ＞０．０５）。结论说明指甲游离端肌酐含量与剪指甲时的ＳＣｒ水平无关，此项检验可以反映病人四个月前的ＳＣｒ水平，故在ＡＲＦ。

Objective To observe the content of fingernail creatine of acute renal failure(ARF) and chronic renal failure(CRF) and to analyse the relationship between the content of fingernail creatine and the surum creatine for diagnosing ARF and CRF.Methods The free edges of the fingernails were clipped for preparation of the extract of fingernail creatine.The creatine content in thirty health persons, ten patients with ARF and twenty-five patients were determined with CRF using the alkaline picronitric acid method. Results The content of fingernail creatine in healthy parsons, patients with ARF,patients with CRF was separately 87.69±28.56、88.20±21.74、126.04±30.67μmol/100g nail. The results showed that the difference between the patients with ARF and the healthy parsons was not significant(P>0.05);that between the patients with CRF and ARF and healthy persons was significant(P<0.001). The surum creatine content of the patients with ARF and CRF obtained four months previously was highly significant(P<0.01),and not,at the time of the content of fingernail creatine Co fingernail clipped(P>0.05). Conclusion The content of fingernail creatine is not related to that of the surum creatine at the time of fingernail clipped. The surum creatine level of the patient before 4 months has a certain clinical value in diagnosing ARF and CRF.