胱抑素C评价肾脏病患儿肾小球滤过率的价值  

Value of cystatin C for the evaluation of glomerular filtration rate in children with renal disease

作　　者：顾建文[1] 姚丽娜[1] 王清平[1] 张炜民[2] 

机构地区：[1]江苏省常州市第一人民医院检验科,江苏常州213003 [2]江苏省人民医院,南京210029

出　　处：《中国实用儿科杂志》2009年第9期702-704,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨血清胱抑素C(Cys C)水平对评估肾脏病患儿肾小球滤过率(GFR)的应用价值。方法研究对象为2006年1月至2007年11月在江苏省常州市第一人民医院肾脏内科的1.5～16.0岁因各种肾脏疾病住院的患儿75例,内生肌酐清除率(GFRCCR)<80mL/min为Ⅰ组,GFRCCR≥80mL/min为Ⅱ组,正常对照儿童50名。比较分析住院患儿和正常对照两组儿童血清Cys C水平、血肌酐(Scr)水平、24h GFRCCR及施瓦兹(GFR-ccr)公式估计的GFR。结果Cys C在Ⅰ、Ⅱ组患儿中差异有统计学意义(P<0.01),肾脏病患儿和对照相比差异有统计学意义;研究组1/Cys C、GFR-ccr、1/Scr与GFR均显著相关(r分别为0.886、0.742,0.451,P均<0.05),以1/Cys C与GFR的相关性最好;ROC曲线表明,在GFRCCR<80mL/min时Cys C的诊断准确性显著优于Scr、GFR-ccr(Z=2.97,P<0.01;Z=2.38,P<0.05)。结论Cys C比Scr、GFR-ccr更能够反映儿童肾滤过功能的损害,建议用血清Cys C作为肾脏病患儿的GFR指标。Objective To investigate the practical value of serum cystatin c （Cys c ） for the evaluation of glomerular filtration rate （GFR） in renal disease children. Methods Fifty children with renal disease and seventy-five without renal disease were enrolled. Serum Cys C and creatinine concentrations（Scr） were measured, 24-hours creatinine clearances （GFRCCR） calculated with Schwartz （ccr）formula were used as the indicator of glomerular filtration rate （GFR）. Re- suits There were great significant differences in Cys C concentrations between I and II renal disease children （t = 9.15, P 〈 0.01）, also between renal disease and without renal disease children. On evaluation of the correlation study for renal function in renal disease child~＇en, although significant relationships were found between GFR 1/Cys C and GFR-ccr, 1/Scr （r = 0.886,0,451,0.742, all P 〈 0.05）levels, the best correlation of GFR was found with Cys C. ROC analysis showed that the diagnostic accuracies of Cys C were significantly higher than those of Scr and Schwartz formula when GFR was less than 80 mL/min （z = 2.97,P 〈 0.O1 ;z = 2.38,P 〉 0.05）. Conclusion Cys C can better reveal the damage to renal filtration function in children than Scr and GFR-ccr, which is suggested to be used as the GFR indicator for children with renal disease.

关 键 词：胱抑素C 肾小球滤过率 肾脏病 儿童 

分 类 号：R72[医药卫生—儿科]