血清半胱氨酸蛋白酶抑制剂C评价糖尿病患者肾小球滤过功能的临床价值  

Clinical value of serum Cystatin C in the evaluation of glomerular filtration function in patients with Diabetes mellitus

作　　者：吴世木 钱耀先 秦苑[1] 吴海婴 张迪[1] 华东[1] 杨叶虹[2] 

机构地区：[1]贵州省兴义市人民医院检验科,562400 [2]复旦大学附属华山医院内分泌科,上海市200040

出　　处：《实用医学杂志》2013年第11期1844-1846,共3页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81000329)

摘　　要：目的:探讨血清胱抑素C(SCys C)评价糖尿病(DM)患者肾小球滤过功能的临床价值。方法 :测定55例DM患者的锝[99mTc]喷替酸盐注射液(99mTc-DTPA)清除率、SCys C、内生肌酐清除率(CCr),以前者作为反映肾小球滤过率(GFR)的金标准,采用ROC曲线分析SCys C、CCr诊断肾小球滤过功能减退的性能。结果:(1)GFR下降组的SCys C显著高于GFR正常组,CCr显著低于GFR正常组(P<0.05)。(2)SCys C、CCr与99mTc-DTPA清除率的相关系数分别为-0.913、0.729(P<0.05)。(3)SCys C诊断肾小球滤过功能减退的AUC显著大于CCr(P<0.05),SCys C最佳阈值(cut-off值)为1.29 mg/L,诊断灵敏度、特异度分别为84.2%、94.4%。结论 :SCys C是反映GFR的理想指标,它对DM患者合并肾脏损伤有较高的诊断价值。Objective To investigate the clinical value of serum Cystatin C （SCys C） in the evaluation of glomerular filtration function in patients with Diabetes Mellitus （DM）. Methods The clearance of Technetium [〈99m〉Tc] pentetate injection （99mTc-DTPA）, which was defined as the gold standard for the judgment of glomerular filtration rate （GFR）, SCys C, creatinine clearance （CCr） were measured in 55 cases of DM, and the ROC curves were used to evaluate the performance of SCys C and CCr in the diagnosis of glomerular fihration dysfunction. Results （1）The SCys C in the GFR-deeline group was significantly higher than that in the GFR- normal group, while the CCr was significantly lower（P 〈 0.05）. （2）The correlation coefficients between SCys C, CCr and 99mTc-DTPA clearance were -0.913 and 0.729 respectively （P 〈 0.05）. （3）The AUC of SCys C in the diagnosis of glomerular filtration dysfunction was significantly larger than that of CCr （P 〈 0.05）, and the best cut- off value of SCys C was 1.29mg/L, which had a sensitivity of 84.2%, specificity of 94.4%. Conclusion The SCys C is an ideal indicator for reflecting the GFR, and it has better value in the diagnosis of kidney damage in patients with DM.

关 键 词：糖尿病 半胱氨酸蛋白酶抑制剂C 肾小球滤过功能 

分 类 号：R692[医药卫生—泌尿科学]