血清胱抑素C在评估重度子痫前期肾功能损害中的价值

Value of serum cystatin C level in assessing renal damage in preeclamptic patients

目的探讨血清胱抑素C在评估重度子痫前期患者肾脏功能中的临床意义。方法分别在中孕和晚孕期测量96例正常妊娠女性和48例重度子痫前期患者的24 h肌酐清除率(CrCl)、血清肌酐(Scr)、胱抑素C(Cys-C)、尿酸(UA)以及微球蛋白(MG)的浓度,对于重度子痫前期患者,继续监测以上指标变化至产后4 d,然后对这些指标进行分析来评估肾小球滤过率的情况。结果正常妊娠女性晚孕期血清Scr、UA和MG浓度显著高于中孕期(P<0.05),而血清Cys-C浓度无显著差异;对于重度子痫前期患者,血清Cys-C水平在晚孕期显著高于中孕期(P<0.05)。病例组和对照组的相关分析结果显示不管在中孕期、晚孕期还是产后血清Cys-C与24 h CrCl均存在显著的负相关关系。结论血清Cys-C水平可以作为一项灵敏和可靠指标来反映重度子痫前期患者产前和产后肾功能变化情况。

Objective To evaluate the significance of the serum cystatin C （Cys-C） in assessing renal dysfunction in preeclamptic women. Methods Ninety-six women with normal pregnancies and 48 with severe preeclampsia were examined for 24-hour creatinine clearance （CrCl）, serum creatinine （Scr）, Cys-C, uric acid （UA） and beta microglobulin （MG） concentrations during the second and third trimesters and postpartum in severe preeclamptic patients. These indexes were analyzed to estimate the glomerular filtration rate. Results The concentrations of Scr, UA and MG were significantly higher in the third trimester than in the second trimester in women with normal pregnancies, where serum Cys-C levels showed no significant variations. Severe preeclamptic patients exhibited significantly higher serum Cys-C levels in the third than in the second trimester. Correlation analyses demonstrated significant negative correlations between Cys-C and 24-hour CrCl in the second and third trimesters in all the 144 pregnant women and in the postpartum period in severe preeclamptic patients. Conclusion Serum Cys-C can serve as a good indicator for assessing renal function in severe preeclamptic women from antepartum to postpartum periods.