胱抑素C在肾功能病变程度中的诊断价值

Diagnostic value of Cystatin C in renal lesions degree

目的探讨胱抑素C(CysC)在肾功能病变程度中的诊断价值。方法将我院2010年2月～2011年4月收治的152例肾病患者,按照肾小球滤过率(GFR)的大小,将其分为肾功能不全代偿组50例(A组),肾功能不全失代偿组40例(B组),肾功能衰竭组35例(C组)和尿毒症组27例(D组),另选取健康体检者40例作为对照组,采用乳胶颗粒增强免疫透射比浊分析法测定四组的血清CysC,采用酶免疫法检测四组的血清肌酐(Scr)、肌酐清除率(Ccr)、尿素(Urea)的水平,并分析血清CysC与Scr、Ccr的相关性。结果 CysC、Scr、Urea在A、B、C、D四组中呈逐渐上升的趋势,两两之间呈显著性差异(P<0.05)。Ccr在A、B、C、D四组中呈逐渐下降的趋势,两两之间呈显著性差异(P<0.05)。CysC在A、B组的异常率均显著高于Scr、Urea的异常率(P<0.05)。CysC、Scr、Urea在A、B、C、D四组中的异常率无显著性差异(P>0.05)。CysC、Scr与GFR呈负相关关系(P<0.05),Ccr与GFR存在正相关关系(P<0.05)。结论血清中CysC是一个更为准确、可靠的反映肾小球滤过功能的指标,可早期反应肾功能损害,且操作简便,不受外界因素干扰,值得临床推广。

Objective To investigate diagnostic value of cystatin C in renal lesions degree.Methods 152 cases of patients with nephropathy in our hospital from February 2010 to April 2011 were selected and divided into four groups,renal failure group was group A（50 cases）,renal insufficiency decompensate group was group B（40 cases）,renal insufficiency was group C（35 cases） and renal failure group was group D（27 cases） in accordance with the glomerular filtration rate（GFR）,40 cases of health examination were chosen as the control group,serum CysC of four groups was detected by the particles of latex enhanced immunoturbidimetric assay,enzyme assay was used for the detection of four serum creatinine（Scr）,creatinine clearance（Ccr）,urea（Urea） level,and analysis of serum CysC and Scr,Ccr correlation.Results CysC,Scr,Urea in group A,B,C,D rised gradually trend,each two had significant difference（P 0.05）.Ccr in group A,B,C,D declined gradually,each two had significant difference（P 0.05）.CysC in A,B group,the abnormal rate of Scr,Urea were significantly higher than the rate of abnormal（P 0.05）.The abnormal rates of CysC,Scr,Urea in group A,B,C,D were no significant difference（P 0.05）.CysC,Scr and GFR showed a negative correlation（P 0.05）,Ccr and GFR had positive correlation（P 0.05）.Conclusion serum CysC is a more accurate,reliable reflect glomerular filtration function,it can be early impairment of renal function,and the operation is simple,without outside interference factors,and is worthy of clinical application.