血清学指标检测在慢性肾功能不全疾病早期诊断和临床分期中的应用价值  

The application value of serological indicator detection in early diagnosis and clinical staging of chronic renal insufficiency

作　　者：邸平[1] 孙京花 张帆[1] DI Ping;SUN Jing-hua;ZHANG Fan(Center of Medical Laboratory, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China)

机构地区：[1]解放军总医院第一医学中心医学检验中心

出　　处：《中国医学装备》2019年第6期76-79,共4页China Medical Equipment

基　　金：国家自然科学基金青年基金(81700077)“局部肾素-血管紧张素系统调控吸入性肺损伤时CD4+T淋巴细胞免疫平衡的机制研究”

摘　　要：目的:通过检测慢性肾功能不全患者血清学指标游离轻链(sFLC)、肌酐(Scr)以及血胱抑素C(CysC)等指标,分析并评估3种血清学检测指标在慢性肾功能不全疾病的诊断及分期中的临床应用价值。方法:选择在医院就诊的155例慢性肾功能不全患者,将5期慢性肾脏疾病(CKD)患者分别纳入CKD1组(2例)、CKD2组(10例)、CKD3组(22例)、CKD4组(43例)和CKD5组(78例);同时选择64名健康查体人员作为健康对照组,采用免疫比浊法检测其血清sFLC;酶法检测其血清Scr和血清CysC等指标,进行结果的比对分析。结果:CKD1组中只有游离轻链κ(κFLC)指标与正常对照组比较差异有统计学意义(t=13.90,P<0.05),其他各指标与正常对照组比较差异均无统计学意义;CKD2组中只有游离轻链λ(λFLC)指标与正常对照组比较差异无统计学意义(t=2.076,P>0.05),其他各指标与正常对照组比较,差异均有统计学意义,从CKD3组开始到CKD5组,各指标与正常对照组比较差异均有统计学意义。结论:sFLC、Scr以及CysC检测在慢性肾功能不全疾病的早期诊断和临床分期中有重要应用价值。Objective: To analyze and assess the clinical application values of three kinds of serological detection indicators in the diagnosis and staging of chronic renal insufficiency through detecting the serological indicators, included serum free light chain (sFLC), serum creatinine ( Scr) and cystatin C (cys C), of patients with chronic renal insufficiency. Methods: 155 patients with chronic renal insufficiency were selected. And patients with chronic kidney disease (CKD) of 5 stages were divided into CKD1 group (2 cases), CKD2 group (10 cases), CKD3 group (22 cases), CKD4 group (43 cases), CKD5 group (78 cases). At the same time, 64 healthy subjects were selected as the healthy control group. The sFLC was detected by immunoturbidimetry. And Scr and serum Cys C were detected by enzymic method. And the results of them were compared and analyzed. Results: Only the κFLC of CKD1 group was significantly different with that of normal control group (t=13.90, P<0.05), and the differences of other indicators between the two group were no significant. Only the λFLC of CKD2 group was no significant difference with that of normal control group (t=2.076, P>0.05), and the differences of other indicators between the two groups were significant. Besides, the differences of each indicators between CKD3 and normal control group, between CKD4 and normal control group, and between CKD5 and normal control group were significant, respectively. Conclusion: The detections of sFLC, Scr and Cys C play important role in the early diagnosis and clinical staging of chronic renal insufficiency.

关 键 词：游离轻链 肌酐 胱抑素C 慢性肾功能不全 

分 类 号：R446.11[医药卫生—诊断学]