血清半胱氨酸蛋白酶抑制剂C在慢性肾病监测中的应用  

The Monitor Application of Serum Cystatin C in Chronic Kidney Disease

作　　者：吴瑜霞[1] 龚兰[1] 陈振宇[1] 杨秀华[1] 杨英为[1] 

机构地区：[1]广州市第一人民医院检验科,广东广州510180

出　　处：《临床医学工程》2010年第12期42-43,共2页Clinical Medicine & Engineering

摘　　要：目的探讨血清半胱氨酸蛋白酶抑制剂C(Cystatin C)在慢性肾脏病监测中的意义。方法采用免疫速率散射比浊法和酶法,检测75例慢性肾病患者血清半胱氨酸蛋白酶抑制剂C(Cystatin C)和血肌酐(Cr)的变化。同时比较它们与99mTc-DTPA清除率测定的肾小球滤过率(GFR)的相关性及其在诊断慢性肾脏病(CKD)患者肾小球滤过功能下降中的敏感度和特异性。结果 75例慢性肾脏病患者相关分析结果显示Cystatin C与金标准的相关系数为(r=-0.681,P<0.001)大于Scr的相关系数(r=-0.595,P<0.001)。不同CKD分期结果显示在GFR正常[≥80ml·(min·1.73m2)-1]时,Cystatin C有52.3%的异常,Scr的异常率仅为14.3%,轻、中度下降期Cystatin C诊断GFR下降的敏感度均优于Scr。结论 Cystatin C可准确反映肾脏滤过功能的改变,与Scr相比其对肾小球滤过功能受损的诊断具有理想的敏感度和特异度,可作为反映GFR新的内源性理想指标。Objective To explore the meaning of monitoring serum Cystatin C in chronic kidney disease. Methods The levels of serum Cystatin C and the amounts of creatinine（Scr） in 75 patients with chronic kidney disease were determined by particle immunonephrology method and enzymeassay. Glomerular filtration rate（GFR） was estimated by the plasma clearance of 99mTc-DTPA. Then compare their dependencies,evaluate the sensitivity and specificity for the diagnosis of chronic kidney disease with GFR reduced. Results The correlation coefficients with 99mTc-DTPA were-0.681 for serum Cystatin C,-0.595 for serum creatinine（all P 0.001） . Compare the sensitivity and specificity with Cystatin C and Scr,the former was better than the latter. Conclusion Serum Cystatin C is a more sensitive and specific maker for GFR.

关 键 词：胱抑素C 肾小球滤过率 慢性肾脏病 

分 类 号：R692[医药卫生—泌尿科学]