血清胱抑素C联合尿微量蛋白测定在老年慢性呼吸衰竭早期肾损伤评估中的应用  

Application of serum cystatin C combined with urine microproteins detection in the assessment of early renal damage in the elderly patients with chronic respiratory failure

作　　者：林桦[1] 殷少军[1] 李瑾[1] 李微[1] 张毅琴[1] 陆卫东[1] 沈瑾[1] 

机构地区：[1]同济大学附属第十人民医院老年科,上海市200072

出　　处：《实用老年医学》2013年第8期631-633,共3页Practical Geriatrics

基　　金：上海市干部保健局科研基金资助项目(2011GB24);上海市卫生局科研基金项目(2010082)

摘　　要：目的探讨血清胱抑素C(Cys-C)联合尿微量蛋白测定对老年慢性呼吸衰竭早期肾损伤的临床意义。方法选取老年慢性阻塞性肺疾病(COPD)30例、老年COPD合并呼吸衰竭30例、正常健康老年人30例,联合检测血清Cys-C、尿液中α1-微球蛋白(α1-MG)、转铁蛋白(TRF)、微量白蛋白(mAlb)。结果老年单纯COPD组血清Cys-C、尿α1-MG、mAlb、TRF检测结果与正常健康老年人比较差异均无统计学意义(P>0.05);老年COPD合并呼吸衰竭组血清Cys-C、尿α1-MG、mAlb、TRF均明显高于健康组和老年单纯COPD组(P<0.05);血清Cys-C阳性率最高,血清Cys-C联合尿α1-MG、TRF、mAlb阳性率分别为83.3%、80.0%、66.7%,优于任何单项检测结果,以Cys-C+α1-MG联合检测阳性率最高。结论血清Cys-C联合尿微量蛋白测定是发现老年COPD合并呼吸衰竭患者早期肾损害的敏感指标。Objective To investigate the clinical significance of the combination detection of serum cystatin C with urine microalbunminuria (mAlb) ,transferrin (TRF) ,alpha-1-microglobulin (α1-MG) in the assessment of early renal damage in the elderly patients with chronic respiratory failure. Methods Thirty cases of chronic obstructive pulmonary disease (COPD) ,30 cases of COPD complicated with respiratory failure and 30 healthy people as normal control were enrolled in this study. The serum level of cystatin C and the urine level of mAlb,TRF and α1-MG were measured,respectively. Results The levels of serum cystatin C,urine α1-MG,urine mAlb,urine TRF showed no significance differences between COPD group and healthy group(P > 0. 05) . The levels of serum cystatin C,urine α1-MG,urine mAlb,urine TRF in COPD complicated with respiratory failure group were significantly higher than those in healthy group and COPD group (P < 0. 05) . Th positive rate of serum cystatin C was 46. 7% ,and the positive rate of the combination detection of serum cystatin C with urine α1-MG,TRF or mAlb was 83. 3% ,80. 0% and 66. 7% ,respectively. The positive rate of combination detection of serum cystatin C with α1-MG was highest. Conclusions The detection of serum cystatin C combined with urine microproteins is sensitive to the early renal damage in the elderly patietns with COPD complicated with respiratory failure.

关 键 词：老年人 呼吸衰竭 血清胱抑素C 尿微量蛋白 肾损伤 

分 类 号：R563.8[医药卫生—呼吸系统]