摘要
目的探讨儿童肾脏疾病患者不同时期血清中胱抑素C（CysC）的变化及其意义。方法应用乳胶颗粒增强免疫比浊法测定182例患者（其中肾功能正常组73例、肾功能不全代偿组44例、肾功能不全失代偿组35例、肾衰竭组22例、肾终末组8例）和70例健康儿童（对照组）的血清CysC、肌酐（Cr）、内生肌酐清除率（Ccr）水平，比较CysC与Cr、Ccr的相关性及受试者工作特征（ROC）曲线下面积。结果血清CysC在肾功能损伤的不同时期均升高，且随着损伤程度的加重而明显升高，与cr呈正相关，与Ccr呈负相关。CysC的ROC曲线下面积为0．764，Cr的ROC曲线下面积为0．725，CysC的ROC曲线下面积大于Cr的ROC曲线下面积。结论CysC能准确地反映肾功能损害的严重程度及肾小球滤过功能，是肾功能损害早期的敏感指标，其灵敏度和特异度优于Cr、Ccr，对儿童肾脏疾病的早期诊断具有重要意义。
Objective To explore the clinical significance of serum concentrations of Cystatin C （CysC） in children with kidney disease in different disease courses. Methods The serum concentrations of CysC, crcatinine（Cr） and endogenous creatinine clearance rate （Cer） were determined in 182 children with kidney disease. They were divided into five study groups：normal renal function group （73 cases）, compensatory renal disfunction group （44 cases）, non-compensatory renal disfunetion group （35 cases）, renal failure group （22 cases ） and end stage of renal failure group （8 cases）. Meanwhile 70 healthy children were involved in control group. Relationships among CysC, Cr and Ccr were calculated and the diagnostic efficiency was assessed by comparing the areas under the ROC curves. Results The serum concentrations of CysC increased in different courses of renal function impairment in children and were significantly related to the severity of impairment. CysC was positively correlated to Cr and negatively correlated to Ccr. The areas under the ROC curves of Cr and CysC were 0.764 and 0.725. Conclusions The serum concentrations of CysC can accurately identify different impairment grades of renal function and the function of glomerular filtration. As an indicator of early reduction of renal function, its sensitivities and specificities are superior to Cr and Ccr. CysC can be a sensitive endogenous marker for glomerular filtration rate determination. With simple, convenient and applicable assays methods, CysC is essential for early diagnosis of children kidney diseases.
出处
《中国医师进修杂志》
2010年第7期27-29,共3页
Chinese Journal of Postgraduates of Medicine
关键词
儿童
肾疾病
胱抑素C
肌酐
内生肌酐清除率
Child
Kidney diseases
Cystatin C
Creatinine
Endogenous crentinine clearance rate
