血清胱抑素C在动态监测移植肾功能中的价值  

Evaluation on the clinical value of serum cystatin C in renal transplant patients

作　　者：王凤清[1] 徐美华[1] 刘奇才[1] 欧启水[1] 

机构地区：[1]福建医科大学附属第一医院检验科,福州350005

出　　处：《中华临床医师杂志（电子版）》2008年第6期23-25,共3页Chinese Journal of Clinicians(Electronic Edition)

基　　金：福建省卫生厅青年科研基金资助项目(2005-2-54)

摘　　要：目的探讨血清胱抑素C(ScysC)在监测肾脏移植患者肾小球滤过率中的应用价值。方法收集26例肾移植病例,分别于术前、术后1、3、5、7d,2周,4周采集血标本,分别测定ScysC、血清肌酐(Scr)、血清尿素(Urea)、内生肌酐清除率(CCr),比较ScysC、Scr与CCr的相关性。结果患者术后随着移植肾功能的恢复,ScysC值持续下降,与术前相比,差异有显著统计学意义(P<0.01)。与术前相比,术后第1天,ScysC下降达51%,明显早于Scr(下降达40%),移植术前与术后不同时期,患者的ScysC与Scr呈正相关,r=0.945;与CCr呈负相关,r=-0.878。当50ml.min-1.1.73m-2<CCr≤80ml.min-1.1.73m-2时,ScysC与CCr的相关性明显优于Scr,二者的相关系数分别为-0.856、-0.645(P<0.05)。其ROC曲线下的面积分别为0.972±0.032、0.926±0.055(P<0.05)。结论ScysC检测能比较准确评价移植肾的肾小球滤过率,优于Scr,具有临床应用价值。Objective To evaluate the clinical value of serum cystatin C （ScysC） in assessing glomerular filtration rate in renal transplant patients. Methods Twenty-six renal transplant patients （ 16 male/10 female） were recruited in the study. SeysC and serum ereatinine （Ser） were determined before surgery, one day, three days, five days, one week, two weeks and four weeks after surgery, respectively. The ereatinine clearance （CCr） was calculated at the same time compare the correlation of SeysC and Ser. Results SeysC and Ser levels significantly decreased with the recovery of allograft function. SeysC showed significant correlation with Ser and CCr （r = 0. 945 and r = - 0. 878 ）. At a CCr level of 50 80 ml · min-1 · 1.73 m-2 ,the correlation between SeysC and CCr （r = -0. 856） was significantly better than that between Ser and CCr （ r = - 0. 645 ） （ P 〈 0. 05 ）. The area under the curve （ AUC ） of ROC for SeysC and Ser are 0. 972 ＋ 0. 032 and 0. 926 ＋ 0. 055 respectively （ P 〈 0. 05 ）. Conclusions SeysC is more sensitive to detect early and moderate deterioration of GFR compared to Ser in adult renal transplant patients.

关 键 词：半胱氨酸蛋白酶抑制剂 肾移植 肾小球滤过率 

分 类 号：R446.1[医药卫生—诊断学] R699.2[医药卫生—临床医学]