血清胱抑素C在狼疮性肾炎早期诊断中的价值

目的探讨血清胱抑素C（CysC）在诊断早期狼疮性肾炎（LN）中的临床意义。方法选择2015年1月至10月111例系统性红斑狼疮（SLE）患者作为疾病组，39例健康体检者作为健康组，分别测定CysC、尿素氮（BUN）、肌酐（CREA）以及尿微量白蛋白（mALB），并记录数据。按照尿微量白蛋白的结果将疾病组进一步分为3组：单纯性SLE组（23例）：尿微量白蛋〈20mg／L；早期LN组（31例）：尿微量白蛋20-200mg／L；LN组（57例）：尿微量白蛋〉200mg／L。比较各组间CysC、BUN和CREA水平的差异。结果早期LN组和LN组的胱抑素C水平明显高于健康组和单纯SLE组，差异有统计学意义（P〈0．05）；LN组血清BUN和CREA水平明显高于健康组、单纯SLE组和早期LN组，差异有统计学意义（P〈0．05）；而早期LN组的血清BUN和CREA水平与健康组、单纯SLE组比较差异无统计学意义（P〉0．05）。CysC与BUN、CREA判断SLE患者肾损伤的阳性率的差异有统计学意义（P均〈0．05）。结论CysC能够反映系统性红斑狼疮早期肾功能损伤，在狼疮性肾炎的早期诊断中有一定的临床应用价值。

Objective To discuss the clinical value of cystatin C in sperm in the diagnosis of the lupus nephritis. Method 111 patients with systemic lupus erythematosus from January 2015 to October 2015 were chosen as a disease group, and 39 healthy persons were chosen as a control group. Their sperm were collected to have a biochemical test and their urine were detected. Record the results of cystatin C （ CysC ） , urea nitrogen （ UREA ） , creatinine （ CREA ） in serum and the levels of the micro albumin （ mALB ） in urine. According to the results of the urine mALB, the disease group can be divided into 3 groups further： the simple SLE group （ 23cases ） ： urine mALB〈20mg/L; the early LN group （ 31cases ） ： urine mALB 20-200mg/L; the LN group： urine mALB〉200mg/L. Compare the results of cystatin C, urea nitrogen and creatinine in serum each group. Results The levels of cystatin C in the early LN group and the LN group were obviously higher than those in the control group and the simple SLE group, the differences were statistically significant （ P〈0.05 ） . The levels of urea nitrogen, creatinine in the LN group were higher than those in the other there groups and the differences were statistically significant （ P〈0.05 ） . The levels of urea nitrogen and creatinine in the early LN group had no statistical difference with the control group and the simple SLE group. The positive rate of cystatin C was higher than those of the urea nitrogen and creatinine in the diagnosis of the early renal damage in the patient with SLE, and the differences were statistically significant （ P〈0.05 ） . Conclusion The levels of cystatin C can reflect the early renal function damage in the patients with systemic lupus erythematosus, which is valuable in the clinical diagnosis of the lupus nephropathy.