血清胱抑素C测定在恶性肿瘤化疗患者肾功能评价中的地位  

The measurement of serum cystatin C for renal function of patients with malignant tumors

作　　者：蔡讯[1] 薛鹏[1] 宋卫峰[1] 顾鸿莉[1] 杨海燕[1] 王理伟[1] 

机构地区：[1]上海交通大学附属第一人民医院肿瘤科,上海200080

出　　处：《肿瘤》2010年第12期1033-1037,共5页Tumor

摘　　要：目的：通过测定恶性肿瘤化疗患者化疗前后血清中血清胱抑素C（cystatin C,Cys C）的表达水平,分析和探讨其在评价肾功能中的作用和地位。方法：110例晚期恶性肿瘤患者,检测其化疗前后血清中血清肌酐（serum creatinine,Scr）、Cys C和内生肌酐清除率（creatinine clearance,Ccr）等指标;分析Cys C表达水平与患者性别、年龄及体能状况评分的关系;接受含铂与非含铂化疗方案患者血清中Cys C和Ccr的表达水平在化疗前后是否存在差异,以及治疗后肾功能轻度受损患者（Ccr5075mL/min）的Cys C表达水平在化疗前后是否存在差异。结果：Cys C的表达水平在不同年龄组（≥70岁和〈70岁）患者中存在差异（P=0.04）,而在性别和体能状态评分中,差异无统计学意义;接受含铂方案化疗患者的Cys C和Ccr表达水平,在化疗前后存在差异（P=0.00和0.00）,而在接受非含铂方案化疗的患者中差异无统计学意义（P=0.07和0.45）;肾功能轻度受损患者的Cys C表达水平化疗前后差异有统计学意义（P=0.03）。结论：在〈70岁以下的恶性肿瘤患者中,检测Cys C可以与Ccr一样监测化疗后患者早期肾功能损害的情况,而对于Ccr轻度下降的患者,检测Cys C的表达水平较检测Scr更灵敏,因此Cys C可以作为替代Ccr对患者肾功能进行评估的可靠指标。Objective：To evaluate the levels of serum cystatin C（Cys C）,and to analyze and discuss its role and status in renal function of patients with malignant tumors.Methods：For 110 patients,to detect the levels of serum creatinine（Scr）and Cys C,calculate the creatinine clearance（Ccr）by Cockcroft-Gault equation,then analyze whether there are differences for Cys C in gender,age and Eastern Cooperative Oncology Group（ECOG）performance status.Whether there are also differences for Cys C and Ccr in patients who receiving platinum-containing protocols or no-platinum-containing protocol.For patients with mildly impaired renal function（Ccr between 50-75mL/min）,whether there are differences for Cys C before and after chemotherapy.Results：For Cys C,there are differences in different age groups（≥70 years and 〈70 years,P=0.04）and no differences in gender and ECOG performance status;there are significant differences for Cys C and Ccr in patients who receiving platinum-containing protocols（P=0.00 and P=0.00,respectively）and no differences for those receiving no-platinum-containing protocols（P=0.45 and P=0.07,respectively）;there are also significant differences for Cys C of patients with mildly impaired renal function before and after chemotherapy（P=0.03）.Conclusion：For patients below 70 years,measuring the levels of serum Cys C,as the same as Ccr,can also monitor renal dysfunction after chemotherapy.Cys C is more sensitive than Scr for patients with mildly impaired renal function early after chemotherapy.Cys C may replace Ccr as a reliable indicator in the assessment of renal function for patients with malignant tumors before and after chemotherapy.

关 键 词：肿瘤 抗肿瘤联合化疗方案 肾功能试验 胱抑素C 

分 类 号：R446.11[医药卫生—诊断学]