血清胱抑素C在肾脏疾病诊断中的临床应用

Clinical use of serum cystatin C in diagnosis of kidney disease

目的探讨血清胱抑素C(CysC)在肾脏疾病诊断中的临床价值。方法将354例肾病患者按肾脏损伤程度分为4组,检测血清BUN、Scr、UA和CysC并进行对比分析,同时比较BUN、Scr、UA、CysC之间的相关性及敏感性。试验设104例健康对照。结果肾功能基本正常组与健康对照组比较CysC差异有统计学意义(P<0.05);随着肾脏损伤程度的加重,BUN、Scr、UA、CysC均显著升高,组间差异有统计学意义(P<0.05);4指标异常率与肾损伤程度呈正相关,其中CysCr=0.979。肾功能轻度异常组Scr异常率最低(37.2%),肾功能重度异常组UA异常率最低(72.9%)。结论 CysC是肾功能早期损害的灵敏诊断指标,CysC和BUN可用于评价肾脏疾病的进展和判断预后,Scr在轻度肾损伤时不敏感,UA不能单独作为评价肾脏疾病的进展和判断预后的指标。

Objective To explore the clinical value of serum cystatin C（CysC） in the diagnosis of kidney disease.Methods Three hundred and fifty-four patients with kidney disease were divided into four groups on the basis of kidney damage.Levels of serum urea（BUN）,creatinine（Scr）,uric acid（Ua）,and CysC were examined and compared and their relevance and sensitivity were contrasted.One hundred and four healthy individuals served as the control group.Results There was a statistically significant difference in abnormal levels of CysC for patients with normal baseline kidney function and the healthy control group（P〈0.05）.Levels of BUN,Scr,Ua,and CysC rose markedly with greater kidney damage,and the difference between the two groups was statistically significant（P〈0.05）.Abnormal levels of the 4 indices were directly related to the degree of kidney damage;of these,CysC had an r of 0.979.Abnormal levels of Scr were detected least often in patients with mild kidney disease（37.2%）;abnormal levels of UA were detected least often in patients with severe kidney disease（72.9%）.Conclusion Serum CysC is a sensitive index for early diagnosis of renal dysfunction;CysC and BUN are ideal indices to evaluate the progression of kidney disease and the patient＇s prognosis.Scr is not sensitive to mild renal dysfunction,and UA alone cannot be used to evaluate the progression of kidney disease and the patient＇s prognosis.