血清Cystatin—C与血肌酐在肾功能评价中的应用  

Utility of Serum Cystatin C and Creatinine in Evaluation of Renal function

作　　者：孙艳虹[1] 姜傥[1] 曾智杰[1] 高玲[1] 

机构地区：[1]中山大学附属第一医院检验医学部,广州510080

出　　处：《现代检验医学杂志》2009年第1期19-23,共5页Journal of Modern Laboratory Medicine

摘　　要：目的通过对血清半胱氨酸蛋白酶抑制剂-C（CystatinC，CysC）与血肌酐（Creatinine，SCr）的平行分析，探讨CysC与SCr之间存在的变化依存关系，建立一种简便的由CysC浓度推算SCr水平的方法，以方便医生在临床实际工作中更好地运用CysC检测指标。方法采用胶乳颗粒增强的免疫透射浊度法（PETIA）测定2500例血清CysC的水平，同时用酶法测定SCr，对两者进行相关性分析，并建立回归方程。结果以CysC 1．02mg／L为参考范围上限，年龄取18～70岁之间，在2500份CysC与SCr测定结果中获得901例进行分析，发现SCr与CysC、性别之间呈显著相关（r=0．84，0．359，P〈0．01）；对CysC与SCr的关系进行逐步回归分析，得到推导方程SCr＝144．28×CysC-106．68＋24．51（男性），显著性概率P〈0．01，该方程具有显著性意义。采用该方程推算CysC的对应SCr水平及分级程度（5级），可以帮助临床医生正确判断患者的肾脏损伤程度、预后并决定治疗方案。为了使用方便，将该方程简化为SCr=145×CysC-105＋25（男性），由原推算方程和简化方程所得SCr推算值与实测值进行相关分析，ro=0．843，rs=0．843，P〈0．01，且经过配对t检验发现两方程推算值与实测值之间差异无统计学意义（Po=0．999，Ps=0．357，均P〉0．05）。结论根据CysC推算SCr水平及分级程度的推导方程（CysC〉1-02mg／L，年龄18～70岁），有助于临床医生更好地使用CysC检测项目，更早期、更少干扰地了解肾小球滤过功能的损伤。Objective To parallelly analyze the concentration of cystatin C and creatinine in serum,to evaluate the clinical dependablity between cystatin C and creatinine,and to establish a simple method to calculate ereatinine level by cystatin C in convenience for doctors to better use cystatin C in clinical work. Methods Serum cystatin C and creatinine were measured in all 2 500 samples and among which 901 data with cystatin C higher than 1.02 mg/L and age from 18 to 70 years old were obtained to analyze the correlation. Results In 901 samples,there was significantly correlation between cystatin C,sex and creatinine（r=0. 84, 0. 359,P〈0. 01）. Serum cystatin C and sex had significant influence on creatinine through partial regression analysis, and then an regressive equation was made ： SCr = 144.28 × CysC- 106. 68 ＋ 24.51 （male）, （P〈 0.01）. Using the estimated equation to calculate the corresponding grade of creatinine would be useful for clinical doctors to judge the renal damage degree,prognosis and therapeutic regimen. For convinence,the original equation was simplified as SCr： 145×CysC-105＋25（male）. There was no significant difference between estimated creatinine values by both original and simplified equation and true values（Po=0. 999, Ps=0. 357,all P〉0. 05）. Conclusion The equation estimated for creatinine level by cystatin C will be helpful for clinical doctors to better use cystatin C and to have the knowledge of the damage of glomerular filtration function earlier and less interference.

关 键 词：血清 半胱氨酸蛋白酶抑制剂-C 肌酐 肾功能 

分 类 号：R392.1[医药卫生—免疫学]