肾损害患者血、尿半胱氨酸蛋白酶抑制剂C的变化  

CHANGES OF SERUM AND URINE CYSTATIN C IN RENAL INJURY PATIENTS

作　　者：王东红 张贺平 李洪娟 王莹 张俊荣 

机构地区：[1]天津市第五小心医院,天津300045

出　　处：《现代预防医学》2010年第24期4691-4692,4694,共3页Modern Preventive Medicine

摘　　要：[目的]观察肾损害患者血清、尿半胱氨酸蛋白酶抑制剂C(CystatinC)的变化。探讨血、尿半胱氨酸蛋白酶抑制剂C测定的临床意义。[方法]80例肾损害患者,健康对照组60例。酶联免疫法测定血清、尿半胱氨酸蛋白酶抑制剂C及血、尿β2-微球蛋白(β2-MG),同时检测血清肌酐(Scr)、尿素氮、肌酐清除率(Ccr)和24h尿蛋白量。[结果]血清肌酐、肌酐清除率与健康对照组无差别;慢性肾小球肾炎患者血半胱氨酸蛋白酶抑制剂C(P﹤0.01)、血β2-MG(P﹤0.05)、尿半胱氨酸蛋白酶抑制剂C(P﹤0.01)、尿β2-MG(P﹤0.05)、尿半胱氨酸蛋白酶抑制剂C/克肌酐(P﹤0.01)、尿β2-MG/克肌酐(P﹤0.05)均高于健康对照组;血清肌酐与健康对照组无统计学差异;糖尿病肾病患者血半胱氨酸蛋白酶抑制剂C(P﹤0.05)、血β2-MG(P﹤0.01)、尿半胱氨酸蛋白酶抑制剂C(P﹤0.05)、尿β2-MG(P﹤0.01)、尿半胱氨酸蛋白酶抑制剂C/克肌酐(P﹤0.01)、尿β2-MG/克肌酐(P﹤0.01)高于健康对照组;血清肌酐与健康对照组无统计学差异;高血压肾病患者血半胱氨酸蛋白酶抑制剂C、血β2-MG、尿CystatinC、尿β2-MG、尿CystatinC/克肌酐、尿β2-MG/克肌酐高于健康对照组(P﹤0.01)。血清CystatinC、血清β2-MG灵敏度高于血清肌酐。[结论]血半胱氨酸蛋白酶抑制剂C是反映肾小球滤过率灵敏指标,通过检测尿半胱氨酸蛋白酶抑制剂C可发现慢性肾小球肾炎、糖尿病肾病及高血压肾病患者肾小管损害。[Objective]To observe the changes of serum and urine cystatin C in patients with renal injury and investigate the clinical significance of serum,urine cystatin C determination.[Methods]There were 80 cases of renal injury patients,60 healthy cases as control group.Determined the serum,urine cystatin C and serum,urinary β2-microglobulin（β2-MG）with ELISA,while tested the serum creatinine（Scr）,serum urea nitrogen,creatinine clearance rate（Ccr）and 24-hour urine protein.[Results]Serum cystatin C（P﹤0.01）,serum β2-MG（P﹤0.05）,urinary cystatin C（P﹤0.01）,urinary β2-MG（P﹤0.05）,the ratio of urinary cystatin C to urinary creatinine（u[cystatin C/Cr]）（P﹤0.01）and the ratio of urinary β2-MG to urinary creatinine（u[β2-MG/Cr]）（P﹤0.05）in patients with chronic glomerulonephritis were significantly higher than those in the control group;serum cystatin C（P﹤0.05）,serum β2-MG（P﹤0.01）,urine cystatin C（P﹤0.05）,urinary β2-MG（P﹤0.01）,the ratio of u[cystatin C/Cr]（P﹤0.01）and the ratio of u[β2-MG/Cr]（P﹤0.01）in patients with diabetic nephropathy were significantly higher than those in the control group;serum cystatin C,serum β2-MG,urine cystatin C,urinary β2-MG,the ratio of u[cystatin C/Cr]and the ratio of u[β2-MG/Cr]in patients with hypertensive nephropathy were significantly higher than those in the control group（P﹤0.01）.The sensitivities of serum β2-MG and serum cystatin C were higher than that of serum creatinine.[Conclusion]Serum cystatin C is the sensitive indicator of changes in GFR.By detecting urinary cystatin C can find renal tubular damage in chronic glomerulonephritis patients,diabetic nephropathy patients and hypertensive nephropathy patients.

关 键 词：肾损害 血清 尿 半胱氨酸蛋白酶抑制剂C 

分 类 号：R692[医药卫生—泌尿科学]