Zhang P-P, Zhan J-F, Xie H-L, Li L-S, Liu Z-H
Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
J Int Med Res. 2010 Mar-Apr;38(2):473-83. doi: 10.1177/147323001003800211.
This study was designed to evaluate the usefulness of serum cystatin C (CysC) as a marker of renal function in 83 patients with diabetic nephropathy, considering multiple factors including tubular function and body mass index. Serum CysC was assayed using a particle-enhanced nephelometric immunoassay and the glomerular filtration rate (GFR) was obtained by measuring the plasma disappearance of the isotope (99m)Tc-diethylenetriamine penta-acetic acid. By comparing the correlation of CysC and serum creatinine (SCr) with GFR, it was concluded that CysC may be a better indicator of GFR than SCr in diabetic patients, in both the early hypertransfusion stage and in the late renal dysfunction stage. CysC showed a slightly higher sensitivity for renal function evaluation than SCr in patients with renal tubular dysfunction and moderate to severe proteinuria. In addition, CysC was not affected by the metabolic index. Thus, CysC may serve as an ideal endogenous marker of GFR in patients with diabetic nephropathy.
本研究旨在评估血清胱抑素C（CysC）作为83例糖尿病肾病患者肾功能标志物的有效性，同时考虑包括肾小管功能和体重指数在内的多种因素。采用颗粒增强散射比浊免疫分析法检测血清CysC，并通过测量同位素（99m）Tc-二乙三胺五乙酸的血浆清除率来获得肾小球滤过率（GFR）。通过比较CysC和血清肌酐（SCr）与GFR的相关性，得出结论：在糖尿病患者的早期高滤过阶段和晚期肾功能不全阶段，CysC可能是比SCr更好的GFR指标。在肾小管功能障碍和中度至重度蛋白尿患者中，CysC对肾功能评估的敏感性略高于SCr。此外，CysC不受代谢指标的影响。因此，CysC可能是糖尿病肾病患者GFR的理想内源性标志物。
