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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,cystatin C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。
Objective: To investigate the sensitivity of serum cystatin C to glomerular filtration rate (GFR) in patients with chronic kidney disease (CKD) and the relationship between cystatin C and GFR, Scr Relationship. To investigate the clinical value of cystatin C in the early diagnosis of renal function changes. METHODS: Ninety patients with chronic kidney disease were enrolled. The severity of the disease was calculated using the modified simplified MDRD equation GFR for each patient calculated GFR = 175 × [PCr] -1.234 × [age (years)] - 0.179 × [women × 0.793] , And 90 healthy individuals were selected as control group. Serum cystatin C concentration was measured by latex particle-enhanced immuno-turbidimetry (PETIA). Serum creatinine and urea nitrogen were also measured in venous blood samples. The patients were grouped according to different GFR criteria to compare the differences among groups and between groups, and to analyze the possible relationships among the indicators. Results: The level of serum cystatin C in CKD2-5 patients was significantly lower than that in the control group (P <0.05), and there was significant difference among the groups. In each phase of CKD, cystatin C was linearly correlated with GFR and various biochemical indexes. The correlation coefficient between cystatin C and GFR was the highest and the correlation was the highest. cystatin C and Scr glomerular filtration rate in the diagnosis of decreased sensitivity, cystatin C higher sensitivity. CONCLUSIONS: Early renal damage caused by Cystatin C is more sensitive than Scr, which can be used as a simple and convenient method for the diagnosis of early renal function changes. It has important clinical significance in the diagnosis of early-stage chronic kidney disease.