血清cystatin C对小儿肾功能受损诊断的评价

Serum cystatin C in evaluation of the diagnosis in children with impaired renal function

目的探讨儿童肾小球肾炎患者血清cystatin C(Cys C)水平与肾功能损害程度之间关系。方法血清Cys C采用乳微粒子增强比浊法测定,血尿素氮(BUN)采用动力学紫外法测定,血肌酐(sCr)采用酶法测定,内生肌酐清除率(Ccr)采用肌氨氧化酶PAP法计算。结果肾小球肾炎患者肾功能正常期Cys C明显高于正常对照组(P<0.01),BUN、sCr与对照组差异无统计学意义(P均>0.05);肾功能不全代偿期,Cys C、sCr与正常对照组差异有统计学意义(P均<0.01),而BUN与正常对照组差异无统计学意义(P>0.05);肾功能不全失代偿期及肾衰竭期,Cys C、BUN、sCr值与正常对照组差异有统计学意义(P均<0.01)。肾小球肾炎各期Cys C与BUN、sCr、Ccr均呈正相关(P<0.01)。结论血清Cys C可敏感地反映肾小球滤过功能受损程度,可作为早期诊断肾小球肾炎的血清学指标。

Objective To study the relationship of serum cystatin C（Cys C）level with renal function in pediatric patients with glomerulonephritis.Methods Serum Cys C level was determined by a particle-enhanced turbidimetric immunoassay.Blood urea nitrogen（BUN）was measured by UV-kinetic assay.Serum creatinine（sCr）was measured by enzymatic assay.Endogenous creatinine clearance rate（Ccr）was calculated by muscle oxidase Peroxidase-Antiperoxidase method.Results In glomerulnephritis patients with normal renal function,the level of Cys C was significantly higher than the control group（P 〈0.01）,while the levels of BUN,sCr,Ccr had no significant difference.In glomerulnephritis patients with compensated renal insufficiency,the levels of Cys C and sCr were significantly higher than the control group（all P 〈0.01）,while the level of BUN had no significant difference.In glomerulnephritis patients with decompensated renal insufficiency,the levels of Cys C,BUN,and sCr were significantly higher than the control group（all P〈 0.01）.In all phases of glomerulonephritis,the Cys C level was positively correlated with BUN,sCr,and Ccr（all P〈 0.01）.Conclusions Serum Cys C can sensitively reflect the degree of glomerular filtration impairment and can be used as the serum marker for early diagnosis glomerulonephritis.