血清半胱氨酸蛋白酶抑制剂C评估肾小球滤过率的临床研究

Clinical study on serum cystatin C evaluating glomerular filtration function

目的评价血清半胱氨酸蛋白酶抑制剂C(cystatin C)在早期肾功能损害患者中作为判断肾小球滤过率(GFR)指标的可行性。方法选择2009年12月至2011年12月在我院就诊的肾脏病患者120例,检测血清肌酐(Scr)及血清cystatin C,采用99mTc-DTPA显像测定GFR作为评价GFR的金标准。将试验对象分为4组,比较各组Scr、内生肌酐清除率(Ccr)、cystatin C与99mTc-GFR的相关性。结果血清cystatin C与99mTc-GFR的相关性较高,与Scr测定值相比差异有统计学意义(P<0.05)。但在肾功能损害严重时,其相关性较差。结论血清cystatin C是反映肾小球滤过功能比较敏感及特异性的指标,尤其在评价早期肾功能损害时意义更大。

Objective To evaluate the feasibility of the cystatin C as an endogenous marker of glomerular filtration rate （GFR）. Methods A total of 120 patients with kidney disease were selected during December, 2009 to December, 2011. Serum creatinine（Scr） and cystatin C were measured. The 99mTc - GFR determined with ECT method was considered to be a gold standard for GFR. These patients were divided into 4 groups, then the coirelation between 99roTc - GFR and the three parameters（ cystatin C, Scr and Ccr） were compared. Results Cystatin C had significant correlation with 99mT~ - GFR. There was significant difference between cystatin C and Scr. When the renal dys- function was more serious, the correlation was poorer. Conclusion Cystatin C is a more satisfactory and economic parameter for evaluating the renhl function, especially evaluating in early renal impairment.