慢性肾脏病不同时期血清CysC、β_2-MG的变化特点及其与Scr的相关性研究

Research on the Characteristic of the Change of Serum Cystatin C and Beta2-microglobulin Concentration in Different Stages of Chronic Kidney Disease and the Correlation with Serum Creatinine.

目的探讨慢性肾脏病(CKD)不同时期血清胱抑素C(cystatin C,CysC)和β2-微球蛋白(β2-MG)的变化特点及其与血肌酐(Scr)的相关性。方法根据肾小球滤过率(GFR)将研究对象分为CKD 1、2、3、4、5期组,测定不同肾功能时期Cy-sC、β2-MG、Scr、尿素氮(BUN)水平,分别与CKD1期组比较并将各期CysC、β2-MG和Scr进行相关性分析。结果 CKD2、3、4、5期组cystatin C、β2-MG与CKD1组比较有统计学意义(P<0.01)。而CKD3、4、5期组SCr、BUN与CKD1组比较才有统计学意义(P<0.01)。相关分析显示,385例患者血清cystatin C与SCr之间呈正相关(r=0.85,P<0.01),β2-MG与SCr之间呈正相关(r=0.88,P<0.01);除CKD2期组SCr与cystatin C、β2-MG没有相关性外,其余各组SCr与cystatin C、β2-MG均有相关性。结论慢性肾脏病患者的血清cysattniC、β2-MG在CKD2期就明显升高,提示在轻度肾功能不全患者中,CysC、β2-MG的灵敏度要明显优于SCr;CysC、β2-MG比SCr能更及时、早期反映GFR的下降。

Objective To investigate the characteristic of the change of serum cystatin C and beta2 - microglobulin concentration in different stages of chronic kidney disease and to study the correlation with serum ereatinine. Methods According to glomerular filtration rate, patients were divided into five groups ：1,2,3,4,5 stages of CKD groups. CysC,β2 - MG,Ser and BUN of 385 CKD patients were detected . Above mentioned chemical examination indexes of CKD 2,3,4,5 stages were compared with CKD1 respectively. CysC and β2 - MG of every CKD stage were processed by correlated analysis with Scr in accordingly CKD stages. Results The level of serum cystatin C and β2 - MG of CKD 2,3,4,5 stages had statistical significance compared to CKD1 stages（ P 〈 0. 01 ） ,while the level of Scr and BUN of CKD 3,4,5 stages had statisticcal significance compared to CKD1 stages（ P 〈 0. 01 ）. The level of serum cystatin C was positively correlated with SCr （r = 0.85 ,P 〈 0. 01 ）and the level of β2 -MG was also positively correlated with SCr （r = 0. 88 ,P 〈 0. 01 ）. Except CKD2 stage, the/eve/of serum cystatin C and beta2 - microglobulin was positively correlated with SCr in other CKD stages. Conclusion Serum cystatin C and β2 -MG concentration of chronic kidney disease obviously increased in CKD2 stage,which indicated that the sensitivity of cystatin C and β2 - MG was better than serum creatinine and they could reflect the decrease of GFR earlier than serum creatinine in mild renal inadequacy patients.