胱抑素C在肾脏疾病中的临床应用

Clinical application of cystatin C in kidney disease

目的探讨肾功能损害时血清胱抑素C(Cystatin C,CysC)作为早期敏感标志物对临床诊断的价值。方法采用胶乳增强透射比浊法测定血清CysC的浓度,同时测定血肌酐。结果血清CysC在健康对照组、肾储备下降组、肾功能不全组、肾功能衰竭组、尿毒症组的值分别为(0.76±0.14)、(1.95±0.61)、(2.78±0.86)、(6.23±1.68)、(7.93±1.25)mg/L,随着肾功能的损害程度增加,血清CysC的浓度升高,相邻各组之间CysC差异均有统计学意义(P<0.01)。肾功能正常组血清CysC值与健康对照组相比差异有统计学意义(P<0.05),而两组血清肌酐值相比差异无统计学意义(P>0.05)。结论血清CysC作为反映肾脏损伤的敏感指标,可以替代内生肌酐清除率来判断肾小球滤过率,因此有更广阔的应用前景。

Objective To discuss the diagnostic value of using serum Cystatin C（CysC） as an early sensitive mark in kidney functional impairment.Methods The latex enhanced immunoturbidimetric method was adopted to test the concentration of serum CysC,and serum creatinine（Scr） was simultaneously detected.Results The value of serum CysC in control group,kidney function reserve descent group,kidney insufficiency group,kidney failure group and uremia group were（0.76±0.14） mg/L,（1.95±0.61） mg/L,（2.78±0.86） mg/L,（6.23±1.68） mg/L and（7.93±1.25） mg/L respectively.With the increase of kidney function impairment,serum CysC concentration was elevated.The difference of serum CysC among adjacent groups had statistical significance（P〈0.05）.The value of CysC in normal kidney function group was statistically different from that in the normal control group,while the Scr values had no statistical difference（P〉0.05）.Conclusion Serum cystatin C is a sensitive mark to reflect the kidney impairment,which could be used to judge the glomerular filtration function instead of the endogenous creatinine clearance（Ccr）.Using cystatin C to evaluate the abnormal glomerular filtration rate（GFR） has a wide prospect.