血清半胱氨酸蛋白酶抑制剂C、视黄醇结合蛋白联合检测在诊断早期肾损伤中的临床意义(1)
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[摘要] 目的 探讨血清半胱氨酸蛋白酶抑制剂C(Cystatin C，Cys C)和视黄醇结合蛋白(retinol binding protein，RBP)联合检测对诊断原发性高血压、2型糖尿病患者早期肾损害的临床价值。 方法 采用Beckman-Coulter全自动生化仪分别检测185例原发性高血压患者、193例2型糖尿病患者及30例健康对照组血清半胱氨酸蛋白酶抑制剂C、视黄醇结合蛋白、尿素氮(BUN)、肌酐(SCr)的含量。 结果 高血压及2型糖尿病患者血清半胱氨酸蛋白酶抑制剂C、视黄醇结合蛋白水平均显著高于对照组(P < 0.01)，血清尿素氮(BUN)、肌酐(SCr)水平与对照组比较差异无统计学意义(P > 0.05)。 结论 血清半胱氨酸蛋白酶抑制剂C、视黄醇结合蛋白可作为诊断患者早期肾损害的敏感指标。
[关键词] 血清半胱氨酸蛋白酶抑制剂C；血清视黄醇结合蛋白；肾损害
[中图分类号] R544.1+4；R587.2 [文献标识码] A [文章编号] 1673-7210(2012)01(b)-049-02
Analysis on early diagnosis of hypertensive and type 2 diabetes nephropathies with cystatin C and retinol binding protein
SHAO Yaoming NI Fangying▲ MA Jian WANG Qiong
Department of Laboratory Medicine, Wuxi People's Hospital Affiliated to Nanjing Medical University, Jiangsu Province, Wuxi 214023, China
[Abstract] Objective To explore the clinical significance of determining cystatin C (Cys C) and retinol binding protein (RBP) in diagnosis of early renal damage in patients with hypertension and type 2 diabetes. Methods Cys C and RBP were detected in 185 hypertension patients and 193 type 2 diabetes patients and 30 controls with auto chemistry analyzer, BUN and SCr were detected at the same time. Results Cys C and RBP in patients with hypertension and type 2 diabetes group were increased significantly compared with those of the control group (P < 0.01); but there was no significant of BUN and SCr among the three groups (P > 0.05). Conclusion Cys C and RBP are good diagnostic markers of early renal damage in patients with hypertension and type 2 diabetes. The combined examination of Cys C and RBP can be more helpful for the diagnosis of early renal damage.
[Key words] Cystatin C; Retinol binding protein; Renal damage
肾脏是人体的重要器官，也是原发性高血压及2型糖尿病常会累及的脏器。肾脏病变的早期阶段是一种非常隐匿的病理过程，进展缓慢，又无特异性的临床表现。肾小球滤过率(GFR)是评价肾功能的重要指标，血BUN、SCr是临床常用的滤过功能指标，但BUN、SCr受多种因素影响，并不能敏感和精确地反映GFR，特别是肾功能轻度损伤时，血BUN、SCr的变化并不明显。临床实践证明：只有当50%以上的有效肾单位受到损害时BUN、SCr才高于正常值。有研究结果表明，血清半胱氨酸蛋白酶抑制剂C(Cys C)和血清视黄醇结合蛋白(RBP)反映肾小球滤过率明显优于血BUN、SCr[1]。本资料通过对原发性高血压患者及2型糖尿病患者血清Cys C、RBP的联合检测，与血清BUN、SCr指标比较 ......
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