Zoch-Zwierz Walentyna, Hackiewicz Lech, Porowski Tadeusz, Wasilewska Anna, Jadeszko Iwona
Akademia Medyczna w Białymstoku, I Klinika Chorób Dzieci SP DSK.
Pol Merkur Lekarski. 2006 Jun;20(120):668-71.
Stone formation precedes long period, when the crystals are accumulated in basement membranes of renal tubules and intestinal tissue. Accumulated, inside of renal tubules crystals and stones in urinary tract cause urinary tract obstruction, what may lead to impairment of renal function. The aim of work was the assessment of serum cystatin C (cys C) concentration in children with urolithiasis, confirmed by the presence of renal stones in renal pelvis in comparison to serum creatinine concentration and creatinine clearance (Cr cl).
Examined group (B) consisted of 30 children aged (13.08 +/- 4.14 years) with urolithiasis, which was divided into 3 subgroups (I, II, Ill) in dependence on stones' diameter (0.35-1.6cm). Control group (C) consisted of 26 healthy children at the same age. Nephelometric method was used to determine serum cystatin C level, Jaffe method to assess serum creatinine and the Schwartz formula to estimate glomerular filtration rate.
In control group (C) serum cys C did not exceed 0.95 mg/l. In group B serum cystatin C and serum creatinine concentration and Cr cl was similar to the results of control group (p > 0.05). However in 16% of children with urolithiasis, in whom the stones of 0.8-1.6cm diameter were found in both renal pelvis, the concentration of serum cys C exceed 1.2 mg/l, and the value differed significantly from the results of control group (p < 0.05). A weak positive correlation between cys C and creatinine concentration and also between cys C and Cr cl was found. The serum cys C concentration in children with single stones of 0.35-0.8 diameter was normal.
Serum cystatin C increases with increased degrees of urolithiasis assessed by stone size and their number in kidney.
结石形成过程持续较长时间,在此期间晶体在肾小管和肠道组织的基底膜中积聚。肾小管内积聚的晶体和尿路结石会导致尿路梗阻,这可能会损害肾功能。本研究的目的是评估经肾盂内肾结石确诊的小儿尿石症患者的血清胱抑素C(cys C)浓度,并与血清肌酐浓度和肌酐清除率(Cr cl)进行比较。
研究组(B)由30名年龄在(13.08±4.14岁)的尿石症患儿组成,根据结石直径(0.35 - 1.6cm)分为3个亚组(I、II、III)。对照组(C)由26名同龄健康儿童组成。采用比浊法测定血清胱抑素C水平,Jaffe法评估血清肌酐,并使用Schwartz公式估算肾小球滤过率。
对照组(C)血清cys C不超过0.95mg/L。B组血清胱抑素C、血清肌酐浓度和Cr cl与对照组结果相似(p>0.05)。然而,在16%的尿石症患儿中,双侧肾盂均发现直径为0.8 - 1.6cm的结石,其血清cys C浓度超过1.2mg/L,该值与对照组结果差异显著(p<0.05)。发现cys C与肌酐浓度之间以及cys C与Cr cl之间存在弱正相关。直径为0.35 - 0.8的单个结石患儿的血清cys C浓度正常。
血清胱抑素C随着根据结石大小及其在肾脏中的数量评估的尿石症程度增加而升高。