中国实验诊断学

目的　确定CystatinC (CC)在成人和儿童中的参考范围 ,并就CystatinC与肌酐 (Cr)在肾小球滤过功能检测中的临床应用进行比较。方法　采用速率散射比浊法测定了 116例正常成人的血清CystatinC ,并进行性别和不同年龄组比较 ,以确定CystatinC在成人中的参考值范围。同时测定了 130例婴幼儿及儿童的血清CystatinC水平。还测定了 10 9例各种疾病患者的血清CystatinC、血清肌酐和内生肌酐清除率 (Ccr)。分别比较CystatinC和肌酐与肌酐清除率的相关性。结果　正常成人血清CystatinC不同性别有显著性差异 (P <0 0 0 1) ,但在同一性别内三个年龄组差异无显著性。将不同年龄组合并后统计参考值范围 ,男性 17～ 6 0岁年龄组为 0 6 2～ 0 91mg/L ,女性 17～ 6 0岁年龄组为 0 5 2～ 0 83mg/L。 0～ 13岁儿童CystatinC变化较大 ,出生后四个月内水平明显高于成人 ,但在出生 5个月以后下降至接近成人参考值范围。血清CystatinC与血清肌酐有显著正线性相关 (P <0 0 0 1) ,与Ccr的对数值呈显著负线性相关 :LogCC =-0 6 0 6LogCcr +1 2 0 9(r =-0 887)。对于肌酐清除率的异常CystatinC比肌酐有更显著的符合率 ,实验中发现 ,肾病门诊Ccr >80ml/min的患者中有 48%显示CystatinC异常 ;6 0岁以上健康体检者中有 30 %可

Objective We determined the reference scope in adults and children, and compared the usefulness of cystatin C and creatinine in the detection of renal filtration dysfunction. Methods We determined the serum cystatin C of 116 adults(58males and 59 females) and 130 children aging between 1 days and 13 years. We also determined the serum creatinine level and the urine creatinine of 109 patients. Results\ The reference scope was 0.62～0.91 mg/L in males adults and 0.52～0.83 mg/L in female adults. There was significant difference between the male and female adult groups (P<0.001). For the pediatric group the interval was 0.8～2.3mg/L in the first five months and reduced to 0.5～1.1 mg/L after five months. Significant positive correlation was observed between serum cystatin C and serum creatinine level. Serum cystatin C and creatinine were negatively and logarithmically correlated to serum creatinine clearance. In addition to this, Cystatin C was found to correlate more accurately with the abnormal creatinine clearance than creatinine. Conclusion We concluded that serum cystatin C could demonstrate the renal filtration dysfunction more sensitively than serum creatinine.