血清胱抑素C在造影剂肾病早期诊断中的价值

摘要

Objective To investigate the clinical significance of serum cystatin C (CysC) in early diagnosis of radiographic contrast nephropathy (CIN). Methods There were 100 patients receiving angiography as the study subjects, and they were divided into CIN group and non-CIN group by their changes of serum creatinine (Scr) value before and after angiography. Each group contained 50 cases. CysC levels of the two groups were detected in 24 h before angiography, and in 8, 24, 48 h after angiography. Comparison was made on changes of serum CysC before and after angiography between the two groups for evaluation of CysC value in early diagnosis of CIN. Results The CIN group had increased serum CysC value in 8 h after angiography, and that received peak value at 24 h then decreased. Compared with that before angiography, the difference was statistically significant (P<0.05). CIN group also had increased serum CysC value than each corresponding time point of the non-CIN group, and the difference had statistical significance (P<0.05). Serum CysC in the CIN group was positively correlated with serum creatinine before angiography and in 24 h after angiography (r=0.395, 0.715). Conclusion In CIN patients, serum CysC can reflect renal function damage quicker than serum creatinine, and it is worthy of clinical promotion and application.%目的：探讨血清胱抑素C(CysC)在早期诊断造影剂肾病(CIN)中的临床意义。方法100例行血管造影的患者为研究对象,根据造影前后血清肌酐(Scr)值的变化分为CIN组和非CIN组,每组50例。分别检测两组造影前24 h内、造影后8、24、48 h CysC的水平,对比两组造影前后血清CysC的变化情况,评估CysC在CIN早期诊断中的价值。结果 CIN组患者的血清CysC在造影后8 h时开始升高,24 h达高峰,随后下降,与造影前比较,差异有统计学意义(P<0.05)；与非CIN组相应时间点相比, CIN组患者的血清CysC也显著增高,差异有统计学意义(P<0.05)；且CIN组患者的血清CysC在造影前及造影后24 h与相应时间点的血清肌酐呈正相关(r=0.870、0.715)。结论在CIN患者中,血清CysC能比血肌酐更早地反映肾功能的损害,值得临床推广应用。