血清巯基蛋白酶抑制肽C诊断肾功能损害的价值  

Value of serum Cystatin C for estimating renal dysfunction

作　　者：李琮辉[1] 周世菊[1] 万卫红[1] 

机构地区：[1]遵义医学院附属医院,563003

出　　处：《贵州医药》2002年第5期387-389,共3页Guizhou Medical Journal

基　　金：贵州省卫生厅科研基金资助

摘　　要：目的探讨血清巯基蛋白酶抑制肽C(CystatinC ,CysC)诊断肾功能损害的价值。方法10 7例病人分别测定CysC、血清肌酐、尿肌酐、内生肌酐清除率 (Ccr)、尿白蛋白、尿视黄醇结合蛋白、尿α1 微球蛋白。以 2 1例健康人作对照 ,根据矫正的Ccr将病人分为 4组。CysC用颗粒增强透射免疫比浊法测定。以Ccr作标准 ,<80ml.min-1/ 1.73m2 为肾功能减退 ,比较各指标检测肾功能损害的敏感性、准确性及与Ccr的相关性。结果正常血清CysC浓度为 1 2 5± 0 14mg/L ,患者各组间差异有显著意义 ;Ccr与上述指标呈负相关 (r分别为 - 0 75 7、- 0 6 4 2、- 0 392、- 0 385、- 0 5 2 1,P <0 0 1) ,Ccr与CysC的相关性优于Ccr与其余指标的相关性 ,CysC的敏感性和准确性较佳。结论 (1)CysC发现肾功能损害较敏感。 (2 )CysC有可能成为检测肾小球滤过功能新的内源性标志物。 (3)用颗粒增强透射免疫比浊法测定CysC ,简便易行 ,迅速及时 。Objective To study the value of serum Cystatin C (CysC) for estimating renal dysfunction. Methods Serum CysC, Creatinine of serum and urine, Creatinine clearance rate (Ccr) and urinary albumin (Ualb), urinary retinal bindine protein (Urbp), Urinary α 1 microglobulin (α 1 mg) of 107 patients were assayed and compared with those of 21 healthy persons as control group. The patients were divided into 4 groups according to the Ccr. CysC was determined by the particle enhanced turbidimetric immunoassay (PETIA). Ccr < 80ml.min -1 /1.73m 2 was regarded as renal dysfunction. The diagnostic accuracy (sensitivity and specilization etc ) was compared. Results Serum CysC was 1.25+0.14mg/L in control group. Serum CysC of patients increased significantly, but Ccr decreased. Ccr negatively correlated with CysC, Scr, Ualb, Urbp, Uα 1-mg respectively( r =-0.757, -0.642, -0.392, -0.385, -0.521, P <0.01). The diagnostic accuracy of CysC was better than that of others. Conclusions (1) Slight renal dysfunction can be found by serum CysC. (2) Serum CysC can be used as a new marker for estimating GFR. (3) CysC can be rapidly and easily assayed by PETIA.

关 键 词：巯基蛋白酶抑制肽C 肌酐清除率 肾功能损害 诊断 

分 类 号：R692[医药卫生—泌尿科学]