血清胱抑素C在评价慢性肾脏病患者肾小球滤过率中的价值  

Value of Serum Cystatin C in Evaluating Glomerular Filtration Rate in Patients with Chronic Kidney Disease

作　　者：王宏儒[1] 杜国伟[1] 鲍晓荣[1] 

机构地区：[1]复旦大学附属金山医院肾内科,上海200540

出　　处：《中国中西医结合肾病杂志》2010年第5期421-423,共3页Chinese Journal of Integrated Traditional and Western Nephrology

摘　　要：目的:探讨血清胱抑素C(CystC)在评价慢性肾脏病(CKD)患者肾小球滤过率中的临床价值。方法:选取2009年4月～2009年11月住院的CKD患者76例,检测其血清CystC浓度,血清肌酐浓度(Scr),以99mTc-二乙三胺五醋酸(99mTc-DTPA)法测定肾小球滤过率(GFR),并用简化MDRD和Cockcroft-Gault(C-G)方程分别估测GFR(M-GFR,C-GFR),以99mTc-GFR作为金标准,比较不同CKD分期间各指标间的相关性及其敏感度和特异度。结果:患者血清CystC、Scr、C-GFR、M-GFR与99mTc-GFR的相关系数分别为-0.81、-0.73、0.90、0.89,P均<0.01,CystC在CKD1～3期与99mTc-GFR均有相关性,相关系数分别为-0.57(P<0.05),-0.44(P<0.05),-0.74(P<0.01),但在4～5期两者无明显相关关系(相关系数-0.30,P>0.05)而Scr、C-GFR、M-GFR与99mTc-GFR仅在CKD3期患者中有相关性;在CKD1期患者中,CystC的敏感性和特异性均高于C-GFR和M-GFR。结论:血清CystC是一个反映CKD患者肾功能的较为敏感的指标,尤其在早期CKD患者中应用价值更大。Objective：To assess the value of serum Cystatin C（Cyst C） in evaluating glomerular filtration rate in patients with chronic kidney disease（CKD）.Methods：Seventy-six hospitalized CKD patients were observed,and the data such as serum cyst C,serum creatinine （Scr） and 99m Tc-GFR were measured.The estimated GFR was calculated by the equation from the Modification of Diet in Renal Disease Study（M-GFR） and Cockcroft-Gault formula（C-GFR）.99mTc-GFR was considered to be a gold standard in evaluating GFR.The correlation between the above four parameters and 99m Tc-GFR was analyzed in every group.The sensitivity and specificity were calculated,too.Results：There were significant correlation between 99m Tc-GFR and Cyst C,Scr,C-GFR and M-GFR,and the pearson coefficient were -0.81,-0.73,0.90,0.89,respectively （all P〈0.01）.There were significant negative correlation between ^99m Tc-GFR and Cyst C in CKD stage 1-3 patients,and the pearson coefficient were-0.57（P〈0.05）,-0.44（P〈0.05）,-0.74（P〈0.01）,respectively.But there were no significant correlation between 99m Tc-GFR and Cyst C in stage 4-5 patients （the pearson coefficient was -0.30,P〉0.05）.Only in stage 3 patients,there were significant correlation between Scr,C-GFR,M-GFR and 99m Tc-GFR.The sensitivity and specificity of Cyst C were higher than C-GFR and M-GFR in all stages of CKD patients,especially in stage 1CKD patients.Conclusion：Serum cystatin C is a sensible index in evaluating renal function in patients with chronic kidney disease,especially in early chronic kidney disease.

关 键 词：血清胱抑素C 慢性肾脏病 肾小球滤过率 

分 类 号：R692[医药卫生—泌尿科学]