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目的 观察血清胱蛋白酶抑制剂 (Cyst-c)浓度对检出高血压、冠心病伴动脉硬化性早期肾损害的价值及西拉普利治疗的效果。方法 对 2 0 1例高血压、冠心病伴有动脉硬化者同时测血Cyst -c和血肌酐(Cr)浓度 ,并设正常对照组。对其中血Cyst-c浓度增高但血Cr浓度正常的 5 0例早期肾损害伴Ⅰ级高血压者 ,给西拉普利 (2 5mg～ 3 75mg/d)治疗 3个月 ,并检测治疗前、后血Cyst-c浓度。结果 2 0 1例动脉硬化者中 ,早期肾损害 92例 (45 77% ) ,肾功能不全 16例 (7 96 % ) ,肾功能正常 93例 (46 2 6 % )。在早期肾损害组 :血Cyst-c浓度明显高于对照组 (P <0 0 0 1) ,而血Cr浓度两组无显著性差异 (P >0 0 5 )。 5 0例早期肾损害伴Ⅰ级高血压者经西拉普利治疗后 ,血Cyst-c浓度较治疗前明显降低 (2 2 4± 0 5 2与 1 86± 0 5 3,P <0 0 0 1)。结论 血Cyst-c能检出血Cr不能检出的早期肾损害 ,西拉普利治疗早期肾损害有明显效果。
Objective To investigate the value of serum cystatin C in detecting hypertension and coronary heart disease with arteriosclerosis and early renal damage and the effect of cilazapril treatment. Methods Serum levels of Cyst-c and serum creatinine were measured simultaneously in 210 patients with hypertension, coronary artery disease with arteriosclerosis and normal control group. Cclazapril (25mg ~ 375mg / d) was given for 3 months in 50 cases of early renal damage with grade 1 hypertension, whose blood Cyst-c concentration was increased but blood Cr concentration was normal. , After the blood Cyst-c concentration. Results Among 210 cases of atherosclerosis, 92 cases (45.77%) had early renal damage, 16 cases (7 96%) had renal insufficiency, and 93 cases (46.26%) had normal renal function. In the group of early renal impairment, the serum concentration of Cyst-c was significantly higher than that of the control group (P <0.01), but there was no significant difference between the two groups (P> 0.05). Serum Cyst-c levels in 50 patients with early renal impairment and grade I hypertension were significantly lower than those before treatment (2 24 ± 0 52 and 1 86 ± 0 53, P 0 00 0 1). Conclusion Blood Cyst-C can detect early kidney damage that can not be detected by blood Cr. Cilazapril treatment of early renal damage has a significant effect.