血清cystatin C,IgA/C3及IgA/C3检测在IgA肾病诊断及预后评估中的临床价值  

Clinical Diagnotic and Prognosis Value of Detecting of Serum Cystatin C,IgA,C3 Level and IgA/C3 Ratio in Patients with IgA Nephropathy

作　　者：彭道荣[1] 王菁[1] 邢瑞青[1] 杨玉琪[1] 张涛[1] 吴永昌[1] 程晓东[1] 张小宁[1] 

机构地区：[1]第四军医大学西京医院,全军临床检验中心,西安710032

出　　处：《现代检验医学杂志》2011年第6期52-54,57,共4页Journal of Modern Laboratory Medicine

摘　　要：目的 探讨IgA肾病患者血清cystatin C,IgA和IgA/C3比值在IgA肾病（IgAN）的诊断及预后中的临床价值.方法 应用乳胶增强散射比浊法测定62例IgAN患者和58例非IgAN患者血清cystatin C,IgA及C3含量,同时对检测结果进行分析.结果 ①IgAN患者血清cystatin C水平[（1.26±0.46）mg/L] 与非IgAN患者血清cystatin C[（1.66±1.17）mg/L] 水平比较,差异有统计学意义（t=-2.50,P〈0.05）;IgAN患者血清IgA/C3比值（2.59±1.41）显著高于非IgAN患者（2.07±1.03）,差异亦有统计学意义（t=2.33,P〈0.05）;而血清IgA含量[（2.44±1.04）g/L]和C3 含量[（1.07±0.27）g/L] 与非IgAN患者比较差异均无统计学显著性意义;② Lee氏分级为Ⅲ,Ⅳ,V级的IgAN患者血清IgA水平及IgA/C3比值均显著高于Lee氏I和Ⅱ级,差异有统计学意义（t=-2.21,P〈0.05;t=-2.04,P〈0.05）;③IgAN患者IgA水平〉3.0 g/L和IgA/C3比值≥2时诊断IgAN的敏感度、特异度、阳性预测值、阴性预测值及Youden指数YI分别为68.42%,51.48%,20.97%,89.66%,0.20和59.68%,56.90%,59.68%,56.90%,0.17.结论 血清IgA/C3比值联合IgA及cystatin C水平可作为IgAN鉴别诊断、病情判断、预后评估的参考指标;血清cystatin C可能是反映IgA肾病中肾小球滤过功能更为敏感的指标.Objective To investigate the clinical values of serum cystatin C, IgA,C3 and IgA/C3 ratio in the diagnosis and prognosis of IgA nephropathy（lgAN）. Methods 62 patients with IgAN and 58 non-lgA nephropathy patients were selected and the levels of serum cystatin C,IgA and C3 were detected with turbidimetric method. Results OThere was significant differences between IgAN patients with the serum cystatin C levels [（1.26±0. 46）mg/L] and non-IgAN patients with the serum cystatin C levels [（1.66± 1. 17）mg/L]（t= -2.50, P〈0. 05）. The serum IgA/C3 ratio of IgAN（2. 59± 1.41） increased significancetly than that of non-IgAN control group （2. 07 ±1.03） （t= 2.33, P〈0. 05）. But compared to the non- IgAN control group non-IgAN control group,the serum lgA [（2.44± 1.04）g/L]and C3 levels [（1.07±0. 27）g/L] of IgAN patients had no significant differences. （2）The serum IgA level and ]gA/C3 ratio of the IgAN patients in I.ee H1 , IV, V grade were significant higher than the patients in Lee I and Ⅱ grade, （ t -2. 21, P〈0. 05 t= -2. 04, P〈0. 05）. （3） The sensitivity, specificity, positive predictive value, negative predictive value, Youden index were 68. 42 %, 51.48 %, 20. 97 %, 89.66 %, 0.20 and 59.68% ,56.90% ,59.68% ,56.90% ,0. 17 when the serum IgA levels 〉3.0 g/L and IgA/C3 ratio ≥2. Conclusion The serum cystatin C,IgA,C3 levels and IgA/C3 ratio could reflect renal injures and could serve as a useful indicator in evaluating the prognosis of IgAN. The serum cystatin C may be more sensitive in reflecting glomerular/iltration （unction in IgAN.

关 键 词：IGA肾病 C3 IgA/C3比值 CYSTATIN C 检测 

分 类 号：R692[医药卫生—泌尿科学] R392.11[医药卫生—外科学]