检测肾小球滤过功能的新方法——血清巯基蛋白酶抑制肽C

Serum cystatin C as a new marker for estimation of glomerular filtration function

目的探讨测定血清巯基蛋白酶抑制肽C(CysC)的方法并评价其检测肾小球滤过功能的价值。方法对照组 2 1例、患者 10 7例 ,用全自动生化分析仪检测CysC、血清肌酐 (Scr)、尿肌酐 ,计算肌酐清除率 (Ccr)。根据Ccr将患者分成 4组。CysC用颗粒增强透射免疫比浊法 ,肌酐用肌氨酸氧化酶 PAP法测定。结果对照组CysC浓度为 1 2 5± 0 14mg/L ,患者组CysC随Ccr下降而升高 ,各组间差异显著 (P <0 0 0 1)。CysC与Ccr的相关性优于Scr与Ccr的相关性。CysC与性别、年龄无相关 ,而Scr男性显著高于女性 (P <0 0 0 1)。受试者工作特征 (ROC)曲线分析 ,CysC区别正常或异常肾功能的准确性较高 ,优于Scr。结论检测肾小球滤过功能CysC较Scr更好 ,不受年龄、性别的影响 ;本法可大批量、快速、准确测定 ,适于临床常规应用。

Objective To study the method of determining serum cystatin C(CysC) and its value for estimation of glomerular filtration function. Methods Twenty-one normal subjects and 107 patients were studied. CysC, serum creatinine(Scr) and urinary creatinine were all assayed . According to creatinine clearance (Ccr), the patients were devided into four groups. CysC were tested by a paticle-enhanced turbidimetric immunoassay. Results CysC concentration in control group were 1.25±0.14 mg/L. In patients, CysC levels were increased significantly with decrease of Ccr. The correlation of CysC and Ccr was superior to that of Scr and Ccr. Scr levels of people with Ccr≥80ml.min -1 /1.73m 2 were significantly higher in men than that in women( P <0.001), while serum CysC showed no correlation to both sex ( P >0.05). Receiver operating characteristic (ROC) plot displayed that the diagnostic accuracy of both serum CysC and Scr were all good in discriminating normal renal function and renal dysfunction, but the former was superior to the latter. Conclusions Serum CysC seems to be better than Scr for estimation of renal function, and it is not influenced by both sex and age. Serum CysC can be accurately, autometically and rapidly assayed by this method, which adapts to routine clinical use.