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目的研究血清胱抑素C在评价慢性肾脏病患者早期肾功能损害方面的临床价值。方法选取2015年2月至2016年2月在本院接受治疗的原发性肾小球肾炎2~4期慢性肾脏病急性肾损伤患者(A/C组)46例、稳定的原发性肾小球肾炎(CKD组)患者32例,检测血清胱抑素C、血肌酐(Scr)水平和肾小球滤过率,对结果进行比较及综合分析。结果在慢性肾脏病基础上,伴急性肾损伤组及不伴急性肾损伤组,胱抑素C水平差异有统计学意义(χ~2=3.793,P=0.017);血清胱抑素C和肌酐水平在慢性肾脏病基础上伴急性肾损伤组相关系数分别为-0.917、-0.783,血清胱抑素C和肌酐水平在不伴急性肾损伤组相关系数分别为-0.854、-0.602,因此两组血清胱抑素C水平与血肌酐水平呈正相关;血清胱抑素C,Scr的AUCROC关系为血清胱抑素C>Scr,并且胱抑素C的AUC~(ROC)=0.984,Scr的AUC~(ROC)=0.916,两者差异有统计学意义(χ~2=1.674,P=0.041)。结论血清胱抑素C在诊断慢性肾脏病基础上急性肾损伤中具有较高的敏感性与特异性,可以作为其诊断指标。
Objective To study the clinical value of serum cystatin C in the evaluation of early renal impairment in patients with chronic kidney disease. Methods From February 2015 to February 2016 in our hospital for treatment of primary glomerulonephritis 2 to 4 chronic kidney disease in patients with acute kidney injury (A / C group) 46 patients with stable primary kidney Thirty-two cases of CKD patients were enrolled in this study. Serum levels of cystatin C, serum creatinine (Scr) and glomerular filtration rate (GFR) were measured. The results were compared and analyzed. Results The levels of cystatin C in patients with and without acute kidney injury were significantly different on the basis of chronic kidney disease (χ ~ 2 = 3.793, P = 0.017). Serum levels of cystatin C and creatinine The correlation coefficient between the level of chronic kidney disease and acute kidney injury group was -0.917, -0.783 respectively. The correlation coefficient of serum cystatin C and creatinine level was -0.854, -0.602 respectively in the group without acute renal injury, so the two groups Serum levels of cystatin C were positively correlated with serum creatinine; AUCROC of serum levels of cystatin C and Scr was serum cystatin C> Scr, and the AUC ROC of cystatin C was 0.984. The AUC of Scr (ROC) = 0.916, the difference was statistically significant (χ ~ 2 = 1.674, P = 0.041). Conclusion Serum cystatin C has high sensitivity and specificity in the diagnosis of acute kidney injury on the basis of diagnosis of chronic kidney disease and can be used as a diagnostic indicator.