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[目的]观察肾损害患者血清、尿半胱氨酸蛋白酶抑制剂C(CystatinC)的变化。探讨血、尿半胱氨酸蛋白酶抑制剂C测定的临床意义。[方法]80例肾损害患者,健康对照组60例。酶联免疫法测定血清、尿半胱氨酸蛋白酶抑制剂C及血、尿β2-微球蛋白(β2-MG),同时检测血清肌酐(Scr)、尿素氮、肌酐清除率(Ccr)和24h尿蛋白量。[结果]血清肌酐、肌酐清除率与健康对照组无差别;慢性肾小球肾炎患者血半胱氨酸蛋白酶抑制剂C(P﹤0.01)、血β2-MG(P﹤0.05)、尿半胱氨酸蛋白酶抑制剂C(P﹤0.01)、尿β2-MG(P﹤0.05)、尿半胱氨酸蛋白酶抑制剂C/克肌酐(P﹤0.01)、尿β2-MG/克肌酐(P﹤0.05)均高于健康对照组;血清肌酐与健康对照组无统计学差异;糖尿病肾病患者血半胱氨酸蛋白酶抑制剂C(P﹤0.05)、血β2-MG(P﹤0.01)、尿半胱氨酸蛋白酶抑制剂C(P﹤0.05)、尿β2-MG(P﹤0.01)、尿半胱氨酸蛋白酶抑制剂C/克肌酐(P﹤0.01)、尿β2-MG/克肌酐(P﹤0.01)高于健康对照组;血清肌酐与健康对照组无统计学差异;高血压肾病患者血半胱氨酸蛋白酶抑制剂C、血β2-MG、尿CystatinC、尿β2-MG、尿CystatinC/克肌酐、尿β2-MG/克肌酐高于健康对照组(P﹤0.01)。血清CystatinC、血清β2-MG灵敏度高于血清肌酐。[结论]血半胱氨酸蛋白酶抑制剂C是反映肾小球滤过率灵敏指标,通过检测尿半胱氨酸蛋白酶抑制剂C可发现慢性肾小球肾炎、糖尿病肾病及高血压肾病患者肾小管损害。
[Objective] To observe the changes of serum and urinary cystatin C in patients with renal damage. To investigate the clinical significance of blood and urine cysteine proteinase inhibitor C determination. [Method] 80 cases of renal damage patients, healthy control group of 60 cases. Serum and urinary cystatin C and blood and urinary β2-microglobulin (β2-MG) were measured by enzyme-linked immunosorbent assay (ELISA), serum creatinine (Scr), urea nitrogen, creatinine clearance (Ccr) Urine protein content. [Results] Serum creatinine and creatinine clearance rates were not different from those in healthy controls. Serum cystatin C (P <0.01), blood β2-MG (P <0.05) Serum creatinine (P <0.01), urinary β2-MG (P <0.05), urinary cystatin C / creatinine (P <0.01) 0.05) were higher than those in healthy control group. There was no significant difference between serum creatinine and healthy control group. Serum cystatin C (P <0.05), blood β2-MG (P <0.01) Cystatin C (P <0.05), urinary β2-MG (P <0.01), urinary cystatin C / creatinine (P <0.01) and urinary β2-MG / <0.01) were higher than those in healthy control group. There was no significant difference between serum creatinine and healthy control group; serum cystatin C, blood β2-MG, urinary Cystatin C, urinary β2-MG, urinary Cystatin C / Creatinine, urinary β2-MG / g creatinine higher than the healthy control group (P <0.01). Serum CystatinC, serum β2-MG sensitivity higher than serum creatinine. [Conclusion] Serum cystatin C is a sensitive indicator of glomerular filtration rate. It can be found in patients with chronic glomerulonephritis, diabetic nephropathy and hypertensive nephropathy by detecting urinary cystatin C Tubule damage.