现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2014年
18期
2733-2734,2737
,共3页
杨沛%汪家毅%陈开春%王丽馨%邓少丽
楊沛%汪傢毅%陳開春%王麗馨%鄧少麗
양패%왕가의%진개춘%왕려형%산소려
肾疾病%肾小球滤过率%敏感性与特异性%肾功能衰竭/诊断%胱抑素C
腎疾病%腎小毬濾過率%敏感性與特異性%腎功能衰竭/診斷%胱抑素C
신질병%신소구려과솔%민감성여특이성%신공능쇠갈/진단%광억소C
Kidney diseases%Glomerular filtration rate%Sensitivity and specificity%Kidney failure/diagnosis%Cystatin C
目的：比较胱抑素C （CysC）、血清肌酐（Scr）和内生肌酐清除率（Ccr）作为肾小球滤过率评估标志的价值。方法选取2012年1~8月在第三军医大学大坪医院健康体检人群和肾内科住院肾病患者共146例，其中健康对照组40例，肾病组106例。采用Beckman DXC-800全自动生化分析仪检测两组受检者CysC、Scr和Ccr。根据Ccr由高到低将肾病患者组分为四组[Ⅰ组（Ccr≥80 mL/min）36例，Ⅱ组（Ccr 50~<80 mL/min）20例，Ⅲ组（Ccr 20~<50 mL/min）30例，Ⅳ组（Ccr<20 mL/min）20例]，比较各组间各指标检测肾功能损害的敏感性及准确性。将Ⅰ组及健康对照组患者分为不同年龄组及不同性别组，分析各组间的Scr和CysC有无差异。结果 CysC随着Ccr降低而升高，二者呈负相关（r=-0.973，P=0.000），Ccr在50～<80 mL/min时，CysC已显著升高，而Scr仍在正常值范围内，说明CysC敏感性较Scr高；Ⅰ组及健康对照组不同年龄组间患者中Scr与CysC比较，差异无统计学意义（P＞0.05），不同性别间CysC比较，差异无统计学意义（P＞0.05），而Scr则男性高于女性，差异有统计学意义（P＜0.01）。Scr随着Ccr降低升高不明显，且其与Ccr的相关性较CysC与Ccr的相关性低。结论 CysC检测肾功能异常的准确性较高，较Scr更加敏感，且与Ccr呈负相关。检测CysC较Ccr更好，不受年龄、性别的影响。
目的：比較胱抑素C （CysC）、血清肌酐（Scr）和內生肌酐清除率（Ccr）作為腎小毬濾過率評估標誌的價值。方法選取2012年1~8月在第三軍醫大學大坪醫院健康體檢人群和腎內科住院腎病患者共146例，其中健康對照組40例，腎病組106例。採用Beckman DXC-800全自動生化分析儀檢測兩組受檢者CysC、Scr和Ccr。根據Ccr由高到低將腎病患者組分為四組[Ⅰ組（Ccr≥80 mL/min）36例，Ⅱ組（Ccr 50~<80 mL/min）20例，Ⅲ組（Ccr 20~<50 mL/min）30例，Ⅳ組（Ccr<20 mL/min）20例]，比較各組間各指標檢測腎功能損害的敏感性及準確性。將Ⅰ組及健康對照組患者分為不同年齡組及不同性彆組，分析各組間的Scr和CysC有無差異。結果 CysC隨著Ccr降低而升高，二者呈負相關（r=-0.973，P=0.000），Ccr在50～<80 mL/min時，CysC已顯著升高，而Scr仍在正常值範圍內，說明CysC敏感性較Scr高；Ⅰ組及健康對照組不同年齡組間患者中Scr與CysC比較，差異無統計學意義（P＞0.05），不同性彆間CysC比較，差異無統計學意義（P＞0.05），而Scr則男性高于女性，差異有統計學意義（P＜0.01）。Scr隨著Ccr降低升高不明顯，且其與Ccr的相關性較CysC與Ccr的相關性低。結論 CysC檢測腎功能異常的準確性較高，較Scr更加敏感，且與Ccr呈負相關。檢測CysC較Ccr更好，不受年齡、性彆的影響。
목적：비교광억소C （CysC）、혈청기항（Scr）화내생기항청제솔（Ccr）작위신소구려과솔평고표지적개치。방법선취2012년1~8월재제삼군의대학대평의원건강체검인군화신내과주원신병환자공146례，기중건강대조조40례，신병조106례。채용Beckman DXC-800전자동생화분석의검측량조수검자CysC、Scr화Ccr。근거Ccr유고도저장신병환자조분위사조[Ⅰ조（Ccr≥80 mL/min）36례，Ⅱ조（Ccr 50~<80 mL/min）20례，Ⅲ조（Ccr 20~<50 mL/min）30례，Ⅳ조（Ccr<20 mL/min）20례]，비교각조간각지표검측신공능손해적민감성급준학성。장Ⅰ조급건강대조조환자분위불동년령조급불동성별조，분석각조간적Scr화CysC유무차이。결과 CysC수착Ccr강저이승고，이자정부상관（r=-0.973，P=0.000），Ccr재50～<80 mL/min시，CysC이현저승고，이Scr잉재정상치범위내，설명CysC민감성교Scr고；Ⅰ조급건강대조조불동년령조간환자중Scr여CysC비교，차이무통계학의의（P＞0.05），불동성별간CysC비교，차이무통계학의의（P＞0.05），이Scr칙남성고우녀성，차이유통계학의의（P＜0.01）。Scr수착Ccr강저승고불명현，차기여Ccr적상관성교CysC여Ccr적상관성저。결론 CysC검측신공능이상적준학성교고，교Scr경가민감，차여Ccr정부상관。검측CysC교Ccr경호，불수년령、성별적영향。
Objective To study the value of cystatin C(CysC),serum creatinine(Scr),endogenous creatinine clearance rate (Ccr) for evaluation of the glomerular filtration rate (GFR). Methods A total of 146 participants,who were enrolled in the Daping Hospital for physical examination and hospitalization in Nephrology Department from January to August of 2012 ,were se-lected,including 40 cases in healthy control group and 106 cases in nephrosis group. Beckman DXC-800 full automatic biochemi-cal analyzer was adopted for the detection of CysC, Scr,and Ccr the participants in the two groups. The nephrotic patients were di vided into four groups[groupⅠ(with Ccr≥80 mL/min,n=36),groupⅡ(with Ccr 50-<80 mL/min,n=20),groupⅢ(with Ccr20-<50 mL/min,n=30)and groupⅣ(with Ccr<20 mL/min,n=20)] according to the levels of Ccr from high to low,to compare the sen-sibility and accuracy of different indicators for detection of renal function damage. The patients in groupⅠand the healthy control group were divided into different age groups and gender groups,to analyze whether or not the difference of Scr and CysC between the two groups existed. Results CysC increased with the decline of Ccr,and they were negative related(r=-0.973,P=0.000). CysC increased significantly when the Ccr was in 50-<80 mL/min,but the Scr was within normal range,which showed that the sensitivity of CysC was higher than that of Scr. There was no statistically significant difference on Scr and Cysc among different age groups in groupⅠand the healthy control group(P>0.05),and the difference of CysC between gender groups had no statistical significance(P>0.05),however,the Scr of the male was significantly higher than that of the female with statistically significant difference(P<0.01). The increase of Scr was not obvious with the decline of Ccr,moreover,the correlation of Scr and Ccr was low-er than that of CysC and Ccr. Conclusions Serum CysC,which is more sensitive than Scr and negatively related with Ccr,has higher accuracy for detection of abnormal renal function. CysC is independent of age and gender, its detection is better than Ccr.
