尿半胱氨酸蛋白酶抑制剂C在肾损害中的临床价值

Clinical value of urine Cystatin C in renal injury

目的 探讨尿半胱氨酸蛋白酶抑制剂C（Cystatin C）、α1微球蛋白（α1-MG）、β2微球蛋白（β2-MG）和N-乙酰-β-D氨基葡萄糖苷酶（N-acetyl-beta-D-glucosa minidase,NAG）对早期肾小管损害的临床价值.方法 选择我科住院的慢性肾脏病患者182例为观察组；另设健康体检者50名为正常对照组.尿Cystatin C、α1-MG、β2-MG采用酶联免疫吸附法检测,尿NAG采用比色法检测,并对2组检测结果进行比较及统计学分析.结果 观察组尿液中各项指标的测定含量明显高于正常对照组（P＜0.05）,通过接受者操作特性曲线（receiver operating characteristic curve,ROC曲线）、诊断试验结果显示尿Cystatin C曲线下面积为0.935,95％可信区间是0.872～0.997,具有统计学差异（P＜0.05）.结论 尿Cystatin C敏感性高于尿α1-MG、β2-MG、NAG酶,可以作为早期肾小管损害的诊断指标.

Objective To investigate the clinical value of urine Cystatin C, α1-MG, β2-MG and NAG in early renal tubular injury. Methods 182 subjects with kidney disease between January 2010 and January 2011 in our hospital were selected as case group, and 50 healthy subjects served as control group. The urine Cystatin C, α1-MG, β2-MG in the two groups were determined by enzyme linked immunoadsorbent assay （ELISA）. Pnitrophenol （PNP） colorimetric analysis was used to detect urine NAG, and results were compared and statistically analyzed. Results The levels of urine each index in the case group were significantly higher than in control group （all P〈0. 05）. The ROC and the diagnostic test results revealed that the area under the curve of urine Cystatin C was 0. 935,and 95 % confidence interval was 0. 872 - 0. 997 （P〈0. 05）. Conclusions The content of urine Cystatin C was more sensitive in the evaluation of early renal injury than α1-MG, β-MG and NAG, and it can be used as a diagnostic index of early renal tubular injury.