血肌酐与胱抑素C对慢性肾脏病患者诊断及预后评估的临床价值  

The role of serum creatinine or Cystatin C in chronic kidney disease staging and prognosis assessment

作　　者：许戎[1] 

机构地区：[1]北京大学第一医院肾内科北京大学肾脏病研究所卫生部重点实验室教育部慢性肾脏病防治重点实验室北京大学,100034

出　　处：《中华检验医学杂志》2014年第6期415-419,共5页Chinese Journal of Laboratory Medicine

摘　　要：慢性肾脏病患者肾功能下降程度与其死亡、心血管事件和进展至终末期肾脏病的风险密切相关，目前临床常用基于血肌酐或胱抑素C的肾小球滤过率估算方程对肾功能进行评估。虽然不断改进基于肌酐的GFR评估公式可以更准确地评估肾功能，但肌酐在估算GFR方面存在的先天缺陷是难以克服的。大量研究发现，以胱抑素C为基础的肾小球滤过率估算方程相对于以血肌酐为基础的肾小球滤过率估算方程在评估慢性肾脏病预后方面具有显著差异，前者特异性更好，可以减少对于低危患者的不必要的肾科就诊和检查，又可以使高危患者得到更准确地辨认从而及时就诊干预。本文着重介绍肌酐和胱抑素C在慢性肾脏病诊断及预后风险评估方面的差异。（中华检验医学杂志，2014，37：415-419）Renal function is closely associated with the risk of mortality ,cardiovascular events ,and progression to end stage of renal disease for patients with chronic kidney disease （ CKD ）.Equations for estimated glomerular filtration rate （ GFR） based on serum creatinine or Cystatin C are frequently used in clinical evaluation of renal function.Although renal function can be more accurately assessed due to improvement in equations for estimated GFR ,it is difficult to overcome the inherent defect of creatinine based GFR estimation.Abundant ,evidence showed that Cystatin C based GFR estimation presented higher accuracy of prognosis assessment in CKD patients than creatinine based GFR estimation ,thus reduce the unnecessary nephrologist referral and measurements for low risk patients ,and also guarantee the timely recognization and intervention for high risk patients.This article deeply reviewed the role of serum creatinine or Cystatin C played in CKD diagnosis and prognosis assessment.

关 键 词：肾功能不全 慢性 肌酸酐 胱抑素C 预后 

分 类 号：R692[医药卫生—泌尿科学]