晚期妊娠女性血清胱抑素C水平变化及其与内生肌酐清除值的相关性研究

Study on the change of serum cystatin C levels and its correlation with endogenous creatinine clearance in the third trimester of pregnant women

目的检测未孕和晚孕状态下的健康育龄期女性血清胱抑素C(CysC)及内生肌酐清除值的水平,探讨血清CysC水平与内生肌酐清除值的相关性及妊娠状态对血清CysC水平的影响。方法以内生肌酐清除值作为评估受试对象肾小球滤过率(GFR)的指标,分析99例未孕女性(未孕组),103例单胎晚期妊娠女性(单胎晚孕组)以及89例双胎晚期妊娠女性(双胎晚孕组)的血清CysC及内生肌酐清除值水平。结果与未孕组相比,单胎晚孕组的血清CysC水平与内生肌酐清除值均明显升高。双胎晚孕组的血清CysC水平较单胎晚孕组升高(P<0.05),而双胎晚孕组的内生肌酐清除值与未孕组相比,差异无统计学意义(P>0.05);与单胎晚孕组相比,双胎晚孕组的内生肌酐清除值水平较低(P<0.01)。对于CysC/内生肌酐清除值的比值,单胎晚孕组与未孕组相比,差异无统计学意义(P>0.05),双胎晚孕组均高于其余两组(P<0.01)。无论是未孕组,还是单胎或双胎晚孕组女性,血清CysC水平的倒数与内生肌酐清除值均具有正相关性。结论血清CysC与个体内生肌酐清除值之间具有相关性,可用作评价未孕及晚孕女性的肾脏功能。晚孕女性血清CysC水平升高可能属于生理性变化,所以临床上利用血清CysC来评价晚孕女性的肾脏功能时,应考虑妊娠状态的影响。

Objective To observe the levels of serum cystatin C(CysC)and endogenous creatinine clearance in the third trimester of healthy pregnanty and healthy non-pregnant women,in order to analyze the correlation between endogenous creatinine clearance and serum CysC,and to investigate the effect of pregnancy on serum CysC in women.Methods Endogenous creatinine clearance was used as an indicator to measure individual glomerular filtration rate(GFR),and the levels of serum CysC and endogenous creatinine clearance in 99 non-pregnant women(non-pregnancy group),103 singleton pregnant women in the third trimester(third trimester of singleton pregnancy group),and 89 twin pregnant women in the third trimester(third trimester of twin pregnancy group)were analyzed.Results Compared with the non-pregnancy group,serum CysC and endogenous creatinine clearance were significantly increased in third trimester of singleton pregnancy group.Serum CysC was significantly increased in third trimester of twin pregnancy group than that in the singleton pregnancy group(P<0.05),but there was no significance on endogenous creatinine clearance level between third trimester of twin pregnancy group and non-pregnancy group(P>0.05).Compared with third trimester of singleton pregnancy group,the endogenous creatinine clearance level in third trimester of twin pregnancy group was lower(P<0.01).For the ratio of serum CysC to endogenous creatinine clearance,there was no significant increase in third trimester of singleton pregnancy group compared with the non-pregnancy group(P>0.05),and third trimester of twin pregnancy group was significantly higher than the other two groups(P<0.01).Reciprocal of serum CysC had positive correlation with endogenous creatinine clearance in non-pregnant group,third trimester of singleton and twin pregnancy group.Conclusion There is a correlation between serum CysC and individual endogenous creatinine clearance,which can be used to evaluate renal function in non-pregnant and the third trimester of pregnant women.The increase of serum CysC level in the third trimester of pregnant women may be a physiological change.In clinical practice,when serum CysC is used to evaluate renal function of pregnant women in the third trimester,the influence of pregnancy status should be considered.