肾移植患者血清胱抑素C及肌酐清除率相关性探究.docVIP

肾移植患者血清胱抑素C及肌酐清除率相关性探究 　 作者：粟宏伟　卢一平　何毅　杨海帆　姜睿　陈同良 【摘要】 　　目的 探讨肾移植患者血清胱抑素C(SCysC)浓度作为移植肾功能测定指标的可行性和临床应用价值。方法 采用颗粒增强透射免疫比浊法(PETIA)分别检测39例初次肾移植患者在术前、术后1周和4周的SCysC水平，并与血清肌酐(Scr)、内生肌酐清除率(Ccr)进行比较分析。结果 肾移植术前与术后，患者的SCysC与Scr、Ccr都具有很好的相关性。SCysC与Scr呈正相关(术前r=0.849；术后r=0.940)；与Ccr呈负相关(术前r=-0.857；术后r=-0.876)；按Ccr分组的统计分析结果显示：不同肾功能水平的SCysC与Ccr的相关性均较Scr与Ccr的相关性相似或更佳。当50≤Ccrlt;80 mL/(min·1.73m2)时，SCysC与Ccr的相关性要明显优于Scr与Ccr的相关性(Plt;0.05)。结论 在肾移植患者中，SCysC浓度与Scr浓度和Ccr有较好的相关性，可成为评估移植肾功能的较理想指标。 【关键词】 血清胱抑素C　肾移植　血清肌酐　肌酐清除率 　　Assessment of the correlation between serum cystatin C and creatinine clearance in patients with renal transplantation 　　ABSTRACT: Objective To evaluate the feasibility and clinical value of serum cystatin C (SCysC) in assessing renal function of patients with renal transplantation. Methods Thirtynine patients with renal transplantation were recruited in the study. SCysC and serum creatinine (Scr) were determined before surgery, 1 week and 4 weeks after surgery, respectively. SCysC was determined by particleenhanced turbidimetric immunoassay(PETIA). The correlations among SCysC, Scr and Ccr were compared by using pearson correlation analysis. Results Either during the preoperative or postoperative period, SCysC shows a significant correlation with Scr and Ccr. SCysC and Scr is positively correlated (r=0.849 preoperatively, and r=0.940 postoperatively). SCysC and Ccr is negatively correlated (r=-0.857 preoperatively, and r=-0.876 postoperatively). SCysC in different Ccr level shows similar or closer correlation with Ccr than Scr does. At a Ccr level of 50-80mL/(min·1.73m2), the correlation between SCysC and Ccr (r=-0.778) is significantly better (Plt;0.05) than that between Scr and Ccr (r=-0.553). Conclusion Both Scr and Ccr correlate well with SCysC in patients with renal transplantation. SCysC can be used as an ideal marker of renal function for clinical monitoring in the adult patients. 　　KEY WORDS: serum cystatin C; renal transplantation; serum creatinine; creat