Objevtive To analyze the sensibility of cystatin C and serum creatinine (Scr)in reflecting glomerular filtration rate (GFR)of CKD, estimate the scope of cystatin C in different CKD stages and assess the clinical value of cystatin C in the early diagnosis of renal function changes. Methods The degree of 90 CKD patients were staged with MDRD formula. 90 healthy persons were as control. Cystatian C was measure with PETIA method. The levels of Scr and Bun in those patients were measured. Results There was statistical difference in the levels of serum cystatin C between those patients in CKD2-5 stages and control groups (P<0. 05). Cystatin C had high sensitivity in diagnosis. 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,对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.
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