胱抑素C、白细胞介素6及急性时相蛋白与慢性肾功能不全的相关性研究

Association of cystatin C,Interleukin-6 and acute phase protein with chronic renal insufficiency

目的探讨血清胱抑素C(Cys C)、白细胞介素6(IL-6)及急性时相蛋白(CRP)在肾功能不全不同损害期的浓度变化及相关性。方法以健康体检者(A组)28例作为健康对照组,将84例肾功能不全患者按内生肌酐清除率(Ccr)分为肾功能不全代偿期组(B组)28例、肾功能不全失代偿期组(C组)28例、肾功能衰竭期组(D组)28例,分别检测血清中血糖(GLU)、肌酐(Scr)、Cys C、尿素(BUN)、IL 6、CRP、铜蓝蛋白(CER)和转铁蛋白(TRF)浓度水平。结果各组之间年龄、GLU水平差异无统计学意义(P>0.05);血清Cys C、IL-6、CRP、TRF浓度水平在各组之间差异均有统计学意义(P<0.01);Scr、BUN和CER浓度水平除在B、A组之间差异无统计学意义(P>0.05),其余各组间差异均有统计学意义(P<0.01或P<0.05)。各组间,血清Cys C、IL-6、CRP、Scr、BUN和CER相互之间呈正相关关系(P<0.01),而与Ccr和TRF呈负相关关系(P<0.01)。结论肾功能不全不同损害期存在程度不同的急性时相反应,反应强度与肾功能损害程度相关;Cys C、IL-6、CRP与其他肾功能指标联合检测对正确评估肾功能损害程度有重要临床价值。

Objective To evaluate the difference and correlation of the serum levels of cystatin C（Cys C）,Interleukin-6（IL- 6） and acute phase reactive protein（CRP） in different stages of chronic renal insufficiency. Methods Eighty-four patients（E group） with renal disfunction were divided into three groups according to their creatinine clearance（Ccr） ：28 cases compensatory stage of renal insufficiency group,28 cases the Loses compensatory stage of renal insufficiency group and 28 cases Kidney function weakness group. 28 cases healthy individuals were normal controls. Serum glucose（GLU）, Cys C, creatinine（ Set）, urea（BUN）, IL-6, C-reactive protein（CRP） ,ceruloplasmin（CER） and transferin（TRF） levels were determined. Results The age and GLU values were no significant difference between every two groups（P2〉 0.05）. The Scr, BUN, CER, Levels were higher in B group than those in A group, but no significant difference could be found （P〉 0.05）. However, the Serum levels of Scr, BUN, CER among B, C, D group and Cys C, IL-6, transferin（TRF） between every two groups were significantly difference（P〈0.01 or P%0.05）, The Cys C, IL-6, CRP,Scr,BUN,CER levels were linearly positively correlated with each other（P〈0.01）,linearly negatively correlated with Ccr and TRF. Conclusion There is an acute phase reaction in all stages of chronic renal insufficiency,and the degree of acute phase reaction is correlated with the severe of kidney impairment. There is important significance for the combined detected of the serum Cys C,IL-6,CRP and other biochemical indicators to evaluate the degree of kidney disease.