胱蛋白酶抑制剂C和内生肌酐清除率与肾脏病理变化的关系探讨

目的　了解血胱蛋白酶抑制剂 (cystatin)C和内生肌酐清除率 (Ccr)与肾脏病理变化的关系。 方法　选择 1999年 1月～ 2 0 0 3年 2月因各种肾脏疾病收治入院行肾穿刺活检术的患儿共 12 4例 ,入院后查血cys tatinC和Ccr ,并行肾穿刺活检术以了解肾脏病理变化 ,然后通过相关及多元线性回归分析了解血cystatinC和Ccr与肾脏病理变化的关系。结果　血cystatinC与肾脏病理变化的复相关系数 (R) =0 .6 91(P <0 .0 1) ,血cys tatinC与肾脏病理变化之间存在直线关系 ,其回归方程为Y =0 .6 0 5 +0 .30 7X1+0 .4 93X2 (F =5 5 .18,P <0 .0 1)。Ccr与肾脏病理变化的R =0 .4 0 5 (P <0 .0 1) ,Ccr与肾脏病理变化之间亦存在直线关系 (F =11.89,P<0 .0 1)。结论　血cystatinC比Ccr更能反映肾脏病理变化的严重程度。血cystatinC和Ccr均与肾间质的变化密切相关 ,尤以血cystatinC更敏感。因此 ,血cystatinC可作为判断肾脏疾病预后的重要参考指标 ,以及时了解肾脏病理变化采取有效的治疗。

Appraisal of relevance of cystatin C, creatitine clearance rate and renal pathology

Objective To investigate the relevance of serum cystatin C,Ccr and renal pathological changes. Methods Serum cystatin C,Ccr and renal pathology were studied in 124 pediatric patients with renal disease.The results were analyzed by correlation and multiple regressive analysis.Results The multiple correlation coefficient between serum cystatin C and renal pathology was 0.691( P <0.01),showing a linear tendency, the results by regressive analysis being Y =0.605+0.307X 1+0.493X 2 ( F =55.18, P <0.01); the multiple correlation coefficient between Ccr and renal pathological changes was 0.405( P <0.01),showing also a linear correlation ( F =11.89, P <0.01).Conclusion The degree of renal pathological changes can be reflected by both serum cystatin C and Ccr,but the former is more sensitive than the latter,hence, the serum cystatin C can be considered as an important reference index for predicting the prognosis of the renal diseases and may reflect the degree of renal pathological changes .