慢性肾脏病患者血清Cystatin C与肾功能的相关研究

摘要

Objevtive To analyze the sensibility of cystatin C and serum creatinine (Scr) in reflecting glomerular filtration rate (GFR)of CKD,estimated the scope of cystatin C in different CKD stages,assess the clinical value of cystatin C in the early diagnosis of renal function changes. Methods Selected 90 CKD patients, divided the severe degree of the 90 CKD patients into five stages based on MDRD formula estimated GFR,and Selected 90 healthy persons as control group,Use PETIA method determine the cystatian C in every patients.The levels of Scr and Bun in those patients were also measurde.then divided Patients based on GFR,Compared between groups,Analysis of the possible relationships among the indicators. Results There is statistical difference in the levels of serum cystatin C between those patients in CKD2-5 stages and control groups (P<0.05),as well as in different stages of the CKD-patients;cystatin C and GFR and other variety of biochemical analysis of linear correlation line,cystatin C and GFR maximum correlation coefficient, the most closely related;cystatin C and Scr were compared in diagnosising the glomerular filtration rate decreased sensitivity, cystatin C was higher sensitivity. Conclusion Cystatin C is more sensitive than serum creatinine in reflecting renal function.Serum cystatin C is a more accurate and reliable reflection of glomerular filtration rate index,so it is a important clinical significance in early diagnosis of chronic kidney disease.%目的:研究慢性肾脏病(CKD)患者各期血清胱抑素C(cystatin C)与血清肌酐(Scr)反应肾小球滤过率的敏感性,以及在CKD分期条件下cystatin C与GFR、Scr的关系.探讨胱抑素C在肾功能改变早期诊断中的临床价值.方法:收集90例慢性肾脏病患者,患者疾病严重程度采用校正后简化MDRD方程GFR=175×[PCr]-1.234×[年龄(岁)]-0.179×[女性×0.793]计算的每个患者GFR值进行分期,并选取90例健康者作为对照组,采用乳胶颗粒增强免疫透射比浊分析法(PETIA)测定每例患者的血清胱抑素C浓度,同时抽取静脉血测定血清肌酐和尿素氮.将患者按不同GFR标准分组,比较组间及组内差异,分析各指标间可能存在的关系.结果:CKD2-5期患者血清cystatin C水平与对照组比较差异有统计学意义(P＜0.05),且各组间比较差异有统计学意义.CKD各期中,cystatinC与GFR及各种生化指标行直线相关分析,cystatin C与GFR相关系数最大,相关性最密切.cystatin C与Scr诊断肾小球滤过功能下降敏感性比较,cystatin C敏感性较高.结论:Cystatin C反应肾功能早期损伤较Scr更敏感,其可以做为诊断早期肾功能改变的简便的测定方法,对早期慢性肾脏病患者的诊断具有重要临床意义.