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目的探讨在血清肌酐正常的老年肾损害患者中,胱抑素(cystatinC,Cys-C)对肾小球滤过率(GFR)评价的意义。方法对2002-11~2003-12泸州医学院附属医院86例有肾损害但血清肌酐(Scr)正常的老年患者,应用乳胶颗粒增强比浊法测定血清中Cys-C浓度,并采用CockCroft-Cault公式计算内生肌酐清除率(Ccr)。分别比较Cys-C与Scr和Ccr的相关性。结果56例Cys-C升高超过正常,占56.1%;比较Ccr≤59mL/min和Ccr>59mL/min两组间的Cys-C质量浓度发现,当Ccr≤50mL/min时,97.1%的患者Cys-C超过正常,在Ccr>59mL/min时,已有44.2%患者Cys-C超过正常。血清Cys-C与Scr存在高度的正直线相关(r=0.89,P<0.01);Cys-C与Ccr存在高度的负直线相关(r=-0.87,P<0.01)。结论在老年患者中,Cys-C比Scr和Ccr更敏感地反映早期肾小球滤过率的下降。
Objective To investigate the significance of cystatin C (Cys-C) in evaluating glomerular filtration rate (GFR) in elderly patients with normal serum creatinine. Methods Serum levels of Cys-C were measured by latex particle turbidimetry in elderly patients with nephrotoxicity and normal serum creatinine (Scr) in 86 patients from November 2002 to December 2003 in Luzhou Medical College Affiliated Hospital. The serum concentrations of Cys- The formula calculates endogenous creatinine clearance (Ccr). Cys-C was compared with Scr and Ccr respectively. Results 56 cases of Cys-C elevated more than normal, accounting for 56.1%; Ccr≤59mL / min and Ccr> 59mL / min Cys-C mass concentration between the two groups found that when Ccr≤50mL / min, 97.1% of patients Cys-C exceeded normal and 44.2% of patients had Cys-C exceeded normal at Ccr> 59 mL / min. There was a high positive correlation between serum Cys-C and Scr (r = 0.89, P <0.01). There was a highly negative linear correlation between Cys-C and Ccr (r = -0.87, P <0.01). Conclusions In elderly patients, Cys-C reflects a more sensitive reduction of early glomerular filtration rate than Scr and Ccr.