血清胱抑素C与IgA肾病Lee氏病理分级的相关性

Relationship of serum cystatin C and Lee's grading of IgA nephropathy

目的探讨血清胱抑素C(Cys C)与IgA肾病Lee氏病理分级的相关性。方法根据Lee氏病理分级标准,244例IgA肾病患者(A组)分为轻度损害组(A1组,108例)、中度损害组(A2组,102例)、重度损害组(A3组,34例);另选取30例健康体检者为对照组(B组)。采用颗粒增强透射免疫比浊法、肌氨酸氧化酶法和尿素酶法分别检测血清Cys C、血清肌酐(SCr)和血尿素氮(BUN)水平,采用慢性肾脏病流行病学合作研究公式(CKD-EPI)估算肾小球滤过率(eGFR)。结果与B组相比,A组以及A2、A3组血清Cys C、BUN、SCr水平升高,eGFR降低(P<0.01)。随着肾脏病变程度加重,血清Cys C、BUN、SCr水平逐渐升高,而eGFR逐渐降低(P<0.05或P<0.01)。IgA肾病Lee氏病理分级与血清Cys C、BUN、SCr呈正相关(r=0.456、0.429、0.454,P<0.01),与eGFR呈负相关(r=-0.331,P<0.01)。A1、A2、A3组血清Cys C的阳性检出率高于BUN和SCr(P<0.05)。结论 Cys C可能是反映IgA肾病早期病变程度的敏感性指标。

Objective To investigate the relationship of serum cystatin C （Cys C） and Lee＇s grading of IgA nephropathy .Methods According to Lee＇s grading standard ,244 patients with IgA nephropathy（group A） were divided into three subgroups of A1（with mild renal damage at grade Ⅰand Ⅱ ,108 cases） ,A2（with moderate renal damage at grade Ⅲ ,102 cases） and A3（with severe renal damage at grade Ⅳ and Ⅴ ,34 cases） .Another 30 healthy people were taken as the controls （group B） .The levels of serum Cys C ,serum creatinine（SCr） and blood urea nitrogen（BUN） were detected by particle-enhanced turbidimetric immunoassay ,sarcosine oxidase assay and urease method , respectively .The estimated glomerular filtration rate （eGFR ） was determined with chronic kidney disease-epidemiology collaboration（CKD-EPI） equation .Results Compared with group B ,the levels of serum Cys C ,BUN and SCr were increased ,while eGFR was decreased in groups of A ,A2 and A3 （P〈0 .01） .With the aggravating degrees of renal lesion ,the levels of serum Cys C ,BUN and SCr were gradually increased ,while eGFR was decreased （P〈0 .05 or P〈0 .01） .Lee＇s grading of IgA nephropathy was positively correlated with serum Cys C ,BUN and SCr（r=0.456 ,0.429 and 0.454 , P〈0 .01） ,but was negatively relevant to eGFR（r= -0.331 ,P〈0 .01） .The positive detection rate of serum Cys C was higher than that of BUN and SCr in groups of A1 ,A2 and A3（P〈0 .01） .Conclusion Cys C may serve as a sensitive biomarker for reflecting the degree of renal damage in the patients with IgA nephropathy in early stage .