血清胱抑素C在产妇早期肾损伤中的临床意义

Clinical significance of cystatin C to early renal damage in puerperae

目的探讨检测产妇血清胱抑素C(CysC)在产妇早期肾损伤中的临床意义。方法测定232例产妇和200例未孕体检健康女性血CysC、肌酐(Cr)、血尿素氮(BUN),检测其尿液RBC、WBC、尿微量清蛋白(UmAlb)及尿比重(SG)。采用多元线性回归方法分析CysC与尿液RBC、WBC、UmAlb及SG关系。结果产妇CysC高于对照组(P<0.05),而产妇的Cr、BUN均低于对照组(P<0.05),产妇尿液RBC、WBC高于对照组(P<0.05),UmAlb高于对照组(P<0.05),SG与对照组差异无统计学意义(P>0.05)。产妇CysC水平与尿液红细胞(RBC)、白细胞(WBC)、UmAlb及SG多元线性回归结果证实,血清CysC(Y)与UmAlb(X1)和SG(X2)存在回归关系,回归方程为Y=12.5+0.161 X1-11.304 X2,与尿RBC、WBC无关。结论产妇血中CysC升高,伴UmAlb升高提示产妇存在早期肾功改变的风险,联合应用监测产妇是否发生早期肾损伤,便于及时保护肾脏。

Objective To investigate the serum concentration of cystatin C in puerperae and the relationship of cystatin C with erythrocyte count,leukocyte count,urine microalbumin and specific gravity.Methods The serum cystatin C,Cr,BUN and urine erythrocyte count,leukocyte count,urine microalbumin and specific gravity were detected in 232 puerperae and 200 healthy women. Multiple linear regression analysis was performed to analyze the relationship of cystatin C with urine erythrocyte count,leukocyte count,urine microalbumin and specific gravity.Results The concentration of cystatin C in the puerperal group was significantly higher than that in the normal control group（P〈0.05）.The concentrations of Cr,BUN in the puerperal group were significantly lower than that in the normal control group （P〈0.05）.The erythrocyte count and the leukocyte count,in the puerperal group were higher than those in the control group（P〈0.05）.The urine microalbumin was higher in the puerperal group than that in the control group（P〈0.05）.There was no significant difference of specific gravity between them.In multiple linear regression analysis,a regression relationship was found between cystatin C（Y）and urine microalbumin（X1 ）and specific gravity（X2 ）.Regression relationship was not found between cystatin C and other indices.Conclusion Elevated serum cystatin C,together with urine microalbumin suggests early renal function change.They can be used to monitor renal function for the puerperae.