类风湿性关节炎患者血清胱抑素C的变化及意义  

Changes of serum cystatin C in patients with rheumatoid arthritis and its significance

作　　者：高登文[1] 俞绍辉[1] 赵东[1] GAO Deng-wen YU Shao-hui ZHAO Dong(Department of Nephropathy Rheumatology,People＇s Hospital of Macheng City in Hubei Province,Macheng 438300, Chin)

机构地区：[1]湖北省麻城市人民医院肾病风湿科,湖北麻城438300

出　　处：《中国当代医药》2017年第5期22-24,共3页China Modern Medicine

摘　　要：目的探讨类风湿性关节炎(RA)患者血清胱抑素C(CysC)水平的变化及临床意义。方法选择2015年6月~2016年9月麻城市人民医院收治的RA患者70例为观察组和70例健康体检者为对照组,在全自动生化分析仪上检测血清CysC、血清肌酐(SCr)。采用MDRD方程7计算肌酐清除率(CCr)。将观察组患者血清CysC与SCr、CCr、C反应蛋白(CRP)、血沉(ESR)、疾病活动关节评分(DAS28)分别进行相关分析。观察组中,30例RA病情活动患者(DAS28≥3.2),给予激素加免疫抑制剂治疗3个月,再次检测CysC等指标,并进行分析。结果观察组患者的CysC水平较对照组明显升高,差异有统计学意义(P<0.01),SCr、CCr与对照组比较,差异无统计学意义(P>0.05)。观察组患者的CysC水平与SCr、CRP、ESR、DAS28成正相关(r=0.297,P=0.014;r=0.321,P=0.008;r=0.566,P=0.000;r=0.383,P=0.000),与CCr成负相关(r=-0.347,P=0.004)。与治疗前比较,治疗后,活动性RA患者CysC、CRP、ESR、DAS28明显下降,差异有统计学意义(P<0.01)。结论 RA患者CysC可能不仅是一个反映早期肾功能损害的指标,而且也是一个反映RA病情活动的标志物。Objective To explore the change of serum cystatin C（CysC） in patients with rheumatoid arthritis（RA） and its clinical significance.Methods 70 patients with RA were selected as observation group and 70 cases of healthy check-up were selected as control group in People′ s Hospital of Macheng City from June 2015 to September 2016.CysC and serum creatinine（SCr） in two groups were detected by using an automatic biochemical analyzer.MDRD equation 7 was used to calculate creatinine clearance（CCr）.The correlation between CysC and SCr,CCr,CRP,ESR,DAS28 was assessed respectively.After application of glucocorticoid combined with DMARDs for three months in 30 patients in the observation group（DAS28≥3.2）,CysC and some other parameters were again detected and analyzed.Results The Cystatin C level in the observation group was significantly higher than that of the control goup（P〈0.01）,while SCr and CCr showed no significant difference between two groups（P〈0.05）.In the observation group,CysC level was positively correlated with SCr,CRP,ESR,DAS28（r=0.297,P=0.014;r=0.321,P=0.008;r=0.566,P=0.000;r=0.383,P=0.000）,and negatively correlated with CCr（r=-0.347,P=0.004）.Compared with before treatment,the CysC,CRP,ESR,and DAS28 in active RA patients decreased significantly after treatment（P〈0.01）.Conclusion In patients with RA,cystatin C may be not only an indicator of early renal impairment but also a marker of disease activity.

关 键 词：关节炎 类风湿 胱抑素C 肾损害 疾病活动度 

分 类 号：R593.22[医药卫生—内科学]