原发性肾小球疾病患者血清、尿Cystatin C与肾脏病理变化的关系

Correlation of Serum Cystatin C,Urinary Cystatin C and Renal Pathology in Primary Glomerulonephritis Patients of Different Patological Types

目的探讨在不同病理类型原发性肾小球肾炎(PGN)患者血清、尿Cystatin C(CysC)水平的差异性及其与肾脏病理变化的关系。方法对行经皮肾穿刺患者检测血清和尿中的Cystatin C,分别与肾小球评分以及肾小管间质评分进行相关性分析。结果在不同病理类型PGN中发现,IgA肾病(IgAN)、局灶增生性肾小球病(FSGS)、膜性肾病(MN)患者的血清、尿Cys-tatin C浓度与正常对照组比较差异有统计学意义(P<0.05),血清Cystatin C与肾小球评分有高度相关性,尿Cystatin C与其相关性相对弱,而与肾小管间质评分的强相关性要优于血清Cystatin C。结论在肾脏病理评估中,任一检测血清Cystatin C或尿Cys-tatin C均能很好地反映慢性肾脏病(CKD)的病理情况,尤其对肾小管间质病变有很大的临床意义。

ObjectiveTo investigate the variability of serum Cystatin C concentration and urinary Cystatin C concentration in primary glomerulonephritis patients of different patological types,and to study the correlation with renal pathological changes. MethodsUrinary Cystatin C was detected before renal biopsy.The two indexes were processed by correlation analysis with glomcrulus scores and renal tubulointerstitial scores respectively.ResultsThe differences of Serum Cystatin C concentration and urinary Cystatin C concentration in IgA nephropathy（IgAN） group,focal segmental glomerulosclerosis group and membranous nephropathy group existed statistical significance as compared to normal control （P〈0.05）.The level of serum Cystatin C was highly correlated with glomcrulus scores,which had an advantage over the level of urinary Cystatin C and glomcrulus scores.But the strong relationship between urinary Cystatin C concentration and renal tubulointerstitial scores was better than that between serum Cystatin C concentration and renal tubulointerstitial scores. ConclusionThe detection of serum Cystatin C or urinary Cystatin C may both reflect pathological changes of chronic kidney disease well.Especially,it has important clinical significance about estimating renal tubulointerstitial damage,in spite of the difference of serum Cystatin C and urinary Cystatin C laying particular emphasis on renal pathology.