胱抑素C评估IgA肾病患者肾纤维化程度及早期肾损害的价值  

Value of cystatin C in evaluating renal fibrosis and early renal impairment in patients with IgA nephropathy

作　　者：向莉[1,2] 周华[1,2] 李旻[1,2] 潘家荣[1,2] 

机构地区：[1]苏州大学附属第三医院 [2]常州市第一人民医院肾脏病科,江苏省213003

出　　处：《江苏医药》2012年第16期1899-1901,共3页Jiangsu Medical Journal

摘　　要：目的探讨胱抑素C(Cys C)评估IgA肾病(IgAN)患者肾纤维化程度及早期肾损害的价值。方法收集IgAN患者共128例作为实验组,行肾小球硬化及肾小管纤维化积分与血和尿Cys C的相关性分析。至随访终点根据CRD分期将实验组分为三个亚组;对照组50例为健康人群。测定四组血尿素氮、肌酐、Cys C,估测肾小球滤过率的水平。结果实验组血清和尿Cys C水平明显高于对照组(P<0.05),与肾小球硬化和肾小管间质纤维化积分均呈显著正相关(P<0.01)。血Cys C、肌酐、尿素氮与肾小球滤过率均有相关性,但各组均以血Cys C与肾小球滤过率的相关系数最大。结论血和尿Cys C水平可能是反映IgAN患者肾小球和肾小管间质纤维化程度的可靠指标,在IgAN患者中定期检测血Cys C水平,有助于发现早期肾损害。Objective To investigate the value of cystatin C（Cys C） in evaluating renal fibrosis and early renal impairment in patients with IgA nephropathy.Methods The glomerular sclerosis and tubulointerstitial fibrosis were scored semi-quantitatively by renal biopsies in 128 patients with IgA nephropathy,who were divided into 3 CRD sub-groups at the end point of obserration.The correlations between serum and urinary Cys C and glomerular sclerosis and tubulointerstitial fibrosis scores were analyzed.Fifty healthy volunteers were taken as the controls.Blood urea nitrogen（BUN）,serum creatinine（SCr）,serum Cys C and creatinine clearane were determined and analyzed.ResultsSerum and urinary Cys C levels were higher in 3 CRD sub-groups than those in control group（P〈0.05） and were positively correlated with the glomerular sclerosis and tubulointerstitial fibrosis scores（P〈0.01）.Serum levels of Cys C,BUN and SCr were correlated with glomerular filtration rate（eGFR）,especially betwee in Cys C and eGFR.Conclusion Serum and urinary Cys C levels may be the reliable markers to reflect glomerular and tubulointerstitial fibrosis and periodical determination of serum Cys C is useful in early finding renal impairment in the patients with IgA nephropathy.

关 键 词：胱抑素C IGA肾病 肾纤维化 

分 类 号：R692[医药卫生—泌尿科学]