Cystatin C对心脏手术患者肾功能的评估价值  

Cystatin C in evaluation of renal function of heart surgical patients

作　　者：岑明秋[1] 张真路[1] 宋杰[1] 

机构地区：[1]武汉亚洲心脏病医院心内科,武汉430022

出　　处：《中国综合临床》2005年第12期1117-1118,共2页Clinical Medicine of China

摘　　要：目的评价胱氨酸蛋白酶抑制剂C(Cystatin C)在心脏手术患者肾功能评估的应用价值。方法测定并统计心脏外科手术患者术前的Cystatin C、血清肌酐、手术后次晨的血清肌酐,并对部分患者手术前进行24h尿内生肌酐清除率的检查,分析Cystatin C、24h尿内生肌酐清除率及与手术前后血清肌酐变化之间的关系。结果Cystatin C对术后肌酐异常的敏感性为68.3%,特异性为16.6%,诊断符合率为68.9%。24h尿肌酐清除率的相关指标为62.5%、55.6%和66.7%。两者比较差异有显著性(P<0.01)。两者联合应用,则相关指标分别为66.7%、77.8%和74.1%。结论Cystatin C是肾小球滤过率监测中的一个较敏感的指标。联合应用Cystatin C和24h尿内生肌酐清除率可以更准确地评估肾功能。Objective To evaluate Cystatin C in the evaluation of renal function of heart operation patients. Methods Preoperative Cystatin C and serum creatinine of heart operation patients with before operation and in the next morning after operation were measured. 24-hour urine creatinine clearance was measured in some patients before operation. The relationship between Cystatin C or 24-hour creatinine clearance and the serum changes of creatinine before and after heart operation was analyzed. Results The sensitivity and specificity of Cystatin C to serum creatinine abnormaity after heart operation and diagnosis consistence rate were 68.3% , 16.6% , and 68.9% , respectively, which of 24-hour creatinine clearance was 62.5% ,55.6% and 66.7%, respectively ,with significant difference between cystatin C and 24 h urine creatinine clearance （ P 〈 0.01 ）. The relevant indexes when combining cyctatin C and 24-h urine creatinine clearance were 66.7% ,77.8% and 74.1%, respectively. Conclusion Cystatin C is a sensitive index in monitoring glomerular filtration,which may be more accurate in evaluating renal function in combination with 24 h urine creatinine clearance.

关 键 词：胱氨酸蛋白酶抑制剂C 24 h尿内生肌酐清除率 肾功能 

分 类 号：R654.2[医药卫生—外科学]