肾移植术后动态监测血清胱抑素C变化的临床意义  

Clinical Significance of the Serum Cystatin C in Patients after Kidney Transplantation

作　　者：谢丽莉[1] 刘娟[1] 高强[1] 孙萍[1] 

机构地区：[1]天津市第一中心医院检验科,300192

出　　处：《天津医药》2010年第7期582-583,共2页Tianjin Medical Journal

基　　金：天津市卫生局科技基金项目(项目编号:07KZ52)

摘　　要：目的:探讨肾移植患者血清胱抑素C(Cystatin c,Cys C)与肾功能的关系。方法:动态检测29例肾移植术后无明显并发症的患者术前、术后第1、3、5、7天血清Cys C、肌酐(SCr)和尿素氮(BUN)浓度。于术前以99Tcm-DTPA血浆清除率(双血浆法)测定肾移植患者肾小球滤过率(GFR)。分析移植组术前Cys C、SCr、BUN与GFR的相关性。同时选择20例健康体检者作为正常对照组。结果:肾移植组术前Cys C、SCr、BUN分别为(4.20±1.32)mg/L、(789.8±318.8)μmol/L和(20.72±9.16)mmol/L,对照组分别为(1.10±0.24)mg/L、(69.8±13.7)μmol/L和(4.85±1.24)mmol/L,肾移植组均高于正常对照组(t分别为12.33、9.17和10.69,P<0.01);术后第1、3、4、7天,Cys C、SCr、BUN均低于术前水平(P<0.01),第1天下降幅度分别为42.9%、37.4%和33.0%。术前Cys C、SCr、BUN与GFR均呈负相关(r分别为-0.892、-0.811和-0.772,P<0.01)。结论:肾移植术后可将CysC作为监测患者肾功能动态变化的指标。Objective：To investigate diagnostic value of serum cystatin C（Cys C）in patients after kidney transplantation.Methods：The serum levels of Cys C,creatinine（SCr） and urea nitrogen（BUN） were dynamically measured preoperative and postoper ative days at one day before 1,3,5 and 7 in 29 patients.Twenty healthy subjects were selected as normal control group.The level of glomerular filtration rate（GFR） was measured by double plasma method.Results：The values of Cys C,SCr and BUN were higher in the transplant group（4.20 mg/L±1.32 mg/L,789.8 μmol/L±318.8 μmol/L and 20.72 mmol/L±9.16 mmol/L） than those in the control（1.10 mg/L±0.24 mg/L,69.8 μmol/L±13.7 μmol/L and 4.85 mmol/L±1.24 mmol/L）before operation（t = 12.33,9.17 and 10.69,P〈 0.01）,and which were decreased（42.9%,37.4% and 33.0%） on the first day after kidney transplant operation（P〈 0.01）.The level of GFR was negatively correlated with Cys C,SCr and BUN（r =-0.892,-0.811 and-0.772,P 〈0.01）.Conclusion：The serum level of Cys C can be used to monitor the dynamic renal function in patients after transplant operation.

关 键 词：肾移植 血清 血尿素氮 西司他汀类 血浆 肾小球滤过率 

分 类 号：R457.2[医药卫生—治疗学]