在接受皮质类固醇治疗的患者中，β-微球蛋白在估算肾小球滤过率方面并不优于胱抑素C。
Beta-trace protein is not superior to cystatin C for the estimation of GFR in patients receiving corticosteroids.
作者信息
Abbink Floor C H, Laarman Céleste A R C, Braam Katja I, van Wijk Joanna A E, Kors Wijnanda A, Bouman Anna A, Spreeuwenberg Marieke D, Stoffel-Wagner Birgit, Bökenkamp Arend
机构信息
Department of Pediatrics, Vrije Universiteit Medical Center, De Boelelaan 1117, NL-1081 HV, Amsterdam, The Netherlands.
出版信息
Clin Biochem. 2008 Mar;41(4-5):299-305. doi: 10.1016/j.clinbiochem.2007.11.012. Epub 2007 Nov 29.
OBJECTIVES
Comparison of the effect of corticosteroid therapy on the diagnostic performance of cystatin C (Cys) and beta-trace protein (bTP), two endogenous markers of GFR.
DESIGN AND METHODS
Out of a total of 193 pediatric inulin clearance studies, a random sample of 85 steroid-free studies served to establish GFR prediction equations (eGFR), which were used to compare the remaining 76 steroid-free and 32 steroid-positive studies (median prednisone dose 33.0 mg m(-2) day(-1)).
RESULTS
We found a positive relationship between prednisone dose and eGFR(betaTP) (b=0.414, p=0.0002) and a negative relationship with eGFR(cys) (b=-0.208, p=0.0091). Only Cys independently predicted GFR below 90 mL min(-1) 1.73 m(-2), both in steroid-positives (b=6.260, p=0.010) and steroid-negatives (b=6.845, p=0.012). Glucocorticoid therapy did not affect the accuracy in estimating GFR within 30% of measured GFR for Cys, while accuracy was lower with bTP (65.6% vs. 81.6%, p=0.08).
CONCLUSION
Glucocorticoids have less impact on the diagnostic accuracy of Cys than bTP.
目的
比较皮质类固醇疗法对胱抑素 C（Cys）和β-微球蛋白（bTP）这两种肾小球滤过率（GFR）内源性标志物诊断性能的影响。
设计与方法
在总共193项儿科菊粉清除率研究中，随机抽取85项无类固醇研究用于建立GFR预测方程（eGFR），并用于比较其余76项无类固醇研究和32项有类固醇研究（泼尼松剂量中位数为33.0 mg m⁻² 天⁻¹）。
结果
我们发现泼尼松剂量与eGFR（bTP）呈正相关（b = 0.414，p = 0.0002），与eGFR（Cys）呈负相关（b = -0.208，p = 0.0091）。仅Cys能独立预测GFR低于90 mL min⁻¹ 1.73 m⁻²，在有类固醇组（b = 6.260，p = 0.010）和无类固醇组（b = 6.845，p = 0.012）中均如此。糖皮质激素疗法不影响Cys在测量GFR的30%范围内估计GFR的准确性，而bTP的准确性较低（65.6%对81.6%，p = 0.08）。
结论
糖皮质激素对Cys诊断准确性的影响小于bTP。
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