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血清胱抑素 C 在子痫前期妇女肾功能评估中的应用。

The application of serum cystatin C in estimating the renal function in women with preeclampsia.

机构信息

Department of Obstetrics, Shenzhen Maternity and Child Healthcare Hospital affiliated to Southern Medical University, Shenzhen, China.

出版信息

Reprod Sci. 2012 Jul;19(7):712-7. doi: 10.1177/1933719111431001. Epub 2012 Jun 5.

Abstract

OBJECTIVE

Serum cystatin C (Cys-C) is known to reflect the glomerular filtration rate (GFR) more precisely in native kidney diseases and renal dysfunctions secondary to other diseases. This study investigated the serum Cys-C in estimating the renal function in preeclamptic women.

METHODS

A total of 96 patients with normal pregnancy (controls) and 48 cases of severe preeclampsia were recruited in this study. We measured the 24-hour creatinine clearance (CrCl), serum creatinine, Cys-C, uric acid (UA), and beta trace protein (BTP) concentrations on all the pregnant women in the second trimester and third trimester and in the postpartum of the patients with severe preeclampsia. Multiple comparisons and correlation analysis were used to analyze the indexes estimating the GFR.

RESULTS

In the normal pregnancies, the concentrations of serum creatinine, UA, and BTP were significantly higher in the third trimester compared to the second trimester, however with no significant differences in the serum Cys-C levels. Comparison between the second and third trimester in patients with severe preeclampsia indicated that significant difference existed in the serum Cys-C, with higher concentration in third trimester. Correlation analyses demonstrated that significant negative correlations could be detected between Cys-C and 24-hour CrCl in the second trimester and third trimester of all the 144 pregnant women and in the postpartum of the patients with severe preeclampsia, and better correlations in normal participants than in participants with preeclampsia.

CONCLUSIONS

Serum Cys-C seems to reflect the GFR precisely in women with severe preeclampsia and can be a good marker to monitor the renal function from antepartum to postpartum.

摘要

目的

血清胱抑素 C(Cys-C)在原发性肾脏疾病和继发于其他疾病的肾功能不全中比血清肌酐(Scr)更能准确地反映肾小球滤过率(GFR)。本研究旨在探讨血清胱抑素 C 在评估子痫前期妇女肾功能中的作用。

方法

本研究共纳入 96 例正常妊娠孕妇(对照组)和 48 例重度子痫前期孕妇。我们在所有孕妇的孕中期、孕晚期及重度子痫前期患者的产后分别测量了 24 小时肌酐清除率(CrCl)、血清肌酐、Cys-C、尿酸(UA)和β微量蛋白(BTP)的浓度。采用多重比较和相关分析来分析用于评估 GFR 的指标。

结果

在正常妊娠中,与孕中期相比,孕晚期血清肌酐、UA 和 BTP 浓度显著升高,但血清 Cys-C 水平无显著差异。与重度子痫前期患者的孕中期相比,孕晚期血清 Cys-C 显著升高。相关性分析表明,在所有 144 例孕妇的孕中期和孕晚期以及重度子痫前期患者的产后,Cys-C 与 24 小时 CrCl 呈显著负相关,且正常孕妇的相关性优于子痫前期患者。

结论

血清 Cys-C 似乎能准确反映重度子痫前期妇女的 GFR,可作为监测从产前到产后肾功能的良好标志物。

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