CAJ | 학술논문

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、Cer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.
목적 탐토인동신장질병환자불동시기혈청중광억소C(CysC)적변화급기의의.방법 응용유효과립증강면역비탁법측정182례환자(기중신공능정상조73례、신공능불전대상조44례、신공능불전실대상조35례、신쇠갈조22례、신종말조8례)화70례건강인동(대조조)적혈청CysC、기항(Cr)、내생기항청제솔(Ccr)수평,비교CysC여Cr、Cer적상관성급수시자공작특정(ROC)곡선하면적.결과 혈청CysC재신공능손상적불동시기균승고,차수착손상정도적가중이명현승고,여Cr정정상관,여Ccr정부상관.CysC적ROC곡선하면적위0.764,Cr적ROC곡선하면적위0.725,CysC적ROC곡선하면적대우Cr적ROC곡선하면적.결론 CysC능준학지반영신공능손해적엄중정도급신소구려과공능,시신공능손해조기적민감지표,기령민도화특이도우우Cr、Ccr,대인동신장질병적조기진단구유중요의의.
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, creatinine(Cr) and endogenous creatinine clearance rate(Ccr) 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 disfunction 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.