血cystatinC及预测方程评价慢性肾脏病患者肾功能的对照研究  

Study on serum cystatin and indirect renal function estimation formulas for the evaluation glomerular filtration rate in chronic kidney disease

作　　者：赵军[1] 李世荣[1] 徐新伟[1] 李新东[1] 隋建霞[1] 尹芳[1] 

机构地区：[1]山东省潍坊市人民医院,261041

出　　处：《中国医学创新》2009年第27期14-16,共3页Medical Innovation of China

摘　　要：目的比较血清半胱氨酸蛋白酶抑制剂(Cystatin C)与临床常用的测定肾小球滤过率(GFR)的方法在慢性肾脏病(CKD)中的诊断价值。方法选取笔者所在科确诊的CKD患者72例,测定血清肌酐(Scr)、尿素氮(BUN)、血β_2-MG和血清Cystatin C,并分别利用MDRD方程、Cockcroft-Gault方程、Cystatin C方程计算GFR,比较各种方法与^(99)Tc^m-DTPA测得GFR之间的相关性;应用受试者工作特征曲线下面积(AUCROC)比较各种方法的准确性。结果血清Cystatin C与GFR呈明显负相关(P<0.01),较Cockcroft-Gault方程计算值及Scr、BUN相关性好。Cys C、1/MDRD-GFR、1/CG-GFR、I/Cys-GFR的AUCROC分别为0.998、0.905、0.865、0.997。结论血清Cystatin C是反映肾小球滤过功能比较敏感的指标,尤其在评价早期肾功能损害时的意义更大。Objective To compare the value of diagnosis of Cystatin C and common clinical methods in evaluating GFR in patients with chronic kidney disease. Methods 72 patients of chronic kidney disease （CKD） according to the NKF K/ DOQI guideline were enrolled in the study. Serum creatinine（Scr） , Blood urea nitrogen （BUN） , serum β2 - MG and serum cystatin C were determined and GFR was calculated by MDRD Equation, Cockcroft - Gauh Equation and Cystatin C Equation, respectively. Correlation between GFR and the above parameters were analyzed and the area under the Receiver Operating Characteristic curve（AUCROC） were used for evaluating the reliability of cystatin C. Results Serum cystatin C was negatively correlated with GFR , with better correlation than that of BUN , Scr, serumβ2 - MG and the value calculated by Cockcroft - Gauh Equation and MDRD Equation. AUCROC of Cys C, 1/MDRD - GFR, 1/CG - GFR,1/Cys - GFR was 0. 998,0. 905,0. 865,0. 997 respectively. Conclusion Serum cystatinC is a more sensitive method in evaluating GFR ,especially in the early stage of renal failure.

关 键 词：半胱氨酸蛋白酶抑制剂C 慢性肾脏病 肾功能 肾小球滤过率 

分 类 号：R692[医药卫生—泌尿科学] R544.1[医药卫生—外科学]