血清γ-痕迹蛋白在儿童肾脏疾病中的应用价值  

Significance of serum cystatin C in detecting the impairment of glomerular filtration rate in children with renal diseases

作　　者：艾洪武[1] 陈莎[1] 邱艳[1] 孙红[1] 游上游[1] 

机构地区：[1]湖北省武汉市儿童医院检验部,湖北武汉430016

出　　处：《临床儿科杂志》2006年第12期987-989,共3页Journal of Clinical Pediatrics

摘　　要：目的探讨血清γ蛳痕迹蛋白(CysC)在儿童肾小球滤过率(GFR)损伤中的诊断价值。方法检测417例各种肾脏疾病患儿的血清CysC、β2MG、Cr及Ccr,分别比较三者之间的相关性及血清CysC诊断肾小球滤过率下降的准确性。结果在Ccr>80ml/(min·1.73m2)的肾脏疾病组,血清CysC和β2MG异常检出率均高于Cr;当Ccr<80ml/(min·1.73m2)时,血清CysC水平的倒数与Ccr显著相关(r=0.710,P<0.01),β2MG的倒数与Ccr显著相关(r=0.702,P<0.01),血清CysC与β2MG显著相关(r=0.897,P<0.01);血清CysC、β2MG和Cr在诊断GFR降低时的ROC曲线下面积(Area±S.E)分别为0.910±0.022、0.894±0.025和0.683±0.034,两者的面积差异有统计学意义(P<0.05)。结论血清CysC能较早地反映儿童肾小球滤过功能受损,在儿童肾脏疾病实验室诊断方面有较好的应用前景。Objectives To evaluate the significance of serum cystatin C in detecting the impairment of glomerular filtration rate （GFR） in children. Methods Serum cystatin C,β2-microglobulin and creatinine clearance rate （Ccr） were determined in 417 children with various renal diseases and the correlation between different parameters and Ccr was assayed, inaddition,the receiver operating characteristics （ROC）analysis was also performed to access their diagnostic accuracy. Results Serum CysC and β2MG were significantly higher than serum Cr when the patients had Ccr 〉 80 ml/（min- 1.73 m^2） in various renal diseases. While significant correlation between 1/CysC and Ccr （r =0.710,P 〈 0.01 ）, 1/β2MG and Ccr （r = 0.702,P 〈0.01 ） ,and positive correlatiori between CysC and β2MG （r = 0.897, P 〈 0.01 ） was found in the patients with their Ccr 〈 80 ml/（min· 1.73 m^2）. ROC plots showed that the area under the ROC curve of CysC ,β2MG,and Cr in detecting the decreasing of GFR were 0.910 ± 0.022, 0.894±0.025 ,and 0.683 ± 0.034 ,respectively. The difference between the areas under the curve （AUC） for serum CysC and Cr, β2MG and Cr （P〈 0.05） was sta- tistically significant. Conclusions Serum CysC can early reflect GFR impairment,and play more important role in making laboratory diagnosis of the renal diseases than β2MG and Cr.

关 键 词：Γ-痕迹蛋白 Β2-微球蛋白 肾小球滤过率 

分 类 号：R726.9[医药卫生—儿科]