慢性肾脏病患者血清胱抑素C和肌酐的临床评估：一项荟萃分析。
Clinical evaluation of serum cystatin C and creatinine in patients with chronic kidney disease: a meta-analysis.
作者信息
Zhang Min, Cao Xueying, Cai Guangyan, Wu Di, Wei Ribao, Yuan Xueli, Bai Xueyuan, Liu Shuwen, Chen Xiangmei
机构信息
State Key Laboratory of Kidney Diseases, Department of Nephrology, Chinese PLA General Hospital and Military Medical Postgraduate College, Beijing, China.
出版信息
J Int Med Res. 2013 Aug;41(4):944-55. doi: 10.1177/0300060513480922. Epub 2013 Jun 12.
OBJECTIVE
Glomerular filtration rate (GFR) is an important indicator of renal function. This meta-analysis aimed to evaluate the diagnostic value of serum cystatin C (CysC) and serum creatinine (SCr) for estimating GFR in patients with chronic kidney disease.
METHODS
Google Scholar, PubMed®, Cochrane Library and China National Knowledge Infrastructure databases were searched, to identify randomized controlled trials that determined the diagnostic value of CysC and SCr, for estimating GFR in patients with chronic kidney disease.
RESULTS
The inclusion criteria were met by 17 studies (total number of patients with chronic kidney disease, 2521). Meta-analysis showed that when the diagnostic cut-off value of GFR was 80-90 ml/min/1.73 m(2), the heterogeneity was modest for CysC (I(2) = 48%, summary sensitivity [SEN] = 0.803, summary specificity [SPE] = 0.821), but there was no heterogeneity for SCr (I(2) = 0.0%, SEN = 0.697, SPE = 0.787). Meta-analysis of the studies demonstrated a significant difference between patients with chronic kidney disease and controls, for CysC and SCr.
CONCLUSIONS
This meta-analysis demonstrated significant correlations between CysC, SCr and GFR. CysC was more sensitive, but less specific, than SCr for the estimation of GFR.
目的
肾小球滤过率（GFR）是肾功能的一项重要指标。本荟萃分析旨在评估血清胱抑素C（CysC）和血清肌酐（SCr）对估计慢性肾脏病患者GFR的诊断价值。
方法
检索谷歌学术、PubMed®、考克兰图书馆和中国知网数据库，以识别确定CysC和SCr对估计慢性肾脏病患者GFR诊断价值的随机对照试验。
结果
17项研究符合纳入标准（慢性肾脏病患者总数为2521例）。荟萃分析表明，当GFR的诊断临界值为80 - 90 ml/min/1.73 m²时，CysC的异质性适中（I² = 48%，汇总敏感度[SEN] = 0.803，汇总特异度[SPE] = 0.821），而SCr无异质性（I² = 0.0%，SEN = 0.697，SPE = 0.787）。对这些研究的荟萃分析表明，慢性肾脏病患者与对照组在CysC和SCr方面存在显著差异。
结论
本荟萃分析表明CysC、SCr与GFR之间存在显著相关性。在估计GFR方面，CysC比SCr更敏感，但特异度更低。
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