慢性腎臟病腎功能評估指標的臨床研究

Clinical study on kidney function markers in Chronic Kidney Diseases

目的探討肌酐(Creatinine,Cr)、胱抑素C(Cystatin C,CysC)在診斷慢性腎臟病中的價值。方法用MDRD及EPI-CKD公式計算eGFR篩查出本院門診及住院病人中腎小球濾過率eGFR介於30~90m l/min/1.73m^(2)的人群作為研究對象,用診斷試驗的ROC曲線來分別評價Cr、CysC診斷慢性腎臟病(Chronic kidney disease,CKD)。結果以eGFR<60ml/ml/min/1.73m^(2)作為診斷CKD截點,Cr和CysC敏感性分別74.39%和85.01%,特異度高分別為95.43%,87.52%,Youden指數低分別為0.698和0.725。結論CysC在及早篩查有CKD風險的人群較Cr有一定優勢,但特異性欠佳。

Objective To investigate the diagnostic value of serum creatinine(Cr)and cystatin C(CysC)levels in chronic kidney disease(CKD).Methods Patients treated in Kiang Wu Hospital whose kidney functions in terms of eGFR within the range of 30-90ml/ml/min/1.73m^(2)were recruited.Diagnostic value comparison of Cr and CysC was performed using diagnostic test model with Receiver Operation Curve(ROC).Results When used eGFR<60ml/ml/min/1.73m^(2)as the diagnostic criteria,the sensitivity of Cr is lower than that of CysC(74.39%vs 85.01%),with a higher specificity(95.43%vs 87.52%),but Youden index is lower(0.698 vs 0.725).Conclusion CysC seems to be better than Cr in the early screening of CKD risk population,but with a lower specificity.