慢性肾衰竭患者治疗前后血清CysC,Hcy及PTH水平变化及临床意义

目的:探讨慢性肾衰竭(CRF)患者治疗前后血清胱抑素C(Cys C)、同型半胱氨酸(Hcy)及甲状旁腺激素(PTH)水平变化及临床意义。方法:筛选2013年12月至2014年12月我院就诊的CRF患者258例作为研究组,并选取同时期健康体检者258例为对照组,研究组患者入院后针对病情给予相应治疗,检测研究组治疗前后血清肌酐(Scr)、尿素氮(BUN)、Cys C、Hcy及PTH水平变化,分析不同分期CRF患者各指标的水平差异,并与对照组进行对比分析,分析Scr、BUN与Cys C、Hcy及PTH的相关性。结果:研究组血清Scr、BUN、PTH、Cys C和Hcy水平均明显高于对照组,异有统计学意义(P0.05),经过治疗后以上各项指标水平较前明显下降,差异有统计学意义(P0.05),但仍明显高于对照组,差异有统计学意义(P0.05);研究组患者Scr、BUN、Cys C、Hcy及PTH水平随着CRF分期发展而上升,其中尿毒症期肾功能衰竭期肾功能失代偿期肾功能代偿期,组间比较差异均有统计学意义(P0.05);采用Pearson相关性分析,研究组患者的Scr、BUN水平分别与Cys C、Hcy及PTH的水平呈正相关(r=0.731、0.642、0.813,P0.05;r=0.682、0.752、0.833,P0.05)。结论:Cys C、Hcy、PTH水平能够反映CRF患者临床治疗效果,反映疾病的严重程度,为CRF患者的诊断和预后提供参考,具有重要的临床意义。

The Clinical Significance and Changes of CysC, Hcy and PTH Levels of Patients with Chronic Renal Failure before and after Treatment

Objective:To observe the clinical significance and changes of serum cystatin C (CysC), homocysteine (Hcy)and parathyroid hormone(PTH)levels in patients with chronic renal failure(CRF)before and after treatment.Methods:258 patients with chronic renal failure treated in our hospital from December 2013 to December 2014 was selected as the research group, 258 contemporaneous healthy check-up cases was selected as control group, research group were given appropriate treatment after admission. Observed serum creatinine(Scr), urea nitrogen(BUN), CysC, Hcy and PTH levels of the research group before and after treatment, and analyzed the levels of each index in CRF patients of different stages, then compared with the control group,analyzed the correlation between Scr, BUN and CysC, Hcy, PTH.Results:The levels of Scr, BUN, CysC, Hcy and PTH in the research group was significantly higher than that in the control group, the difference was statistically significant(P<0.05). After treatment, the levels of each index in the research group declined significantly, the difference was statistically significant(P<0.05), but it was still significantly higher than that in the control group, the difference was statistically significant (P<0.05).In the research group, the Scr, BUN, CysC, Hcy and PTH levels rised with the development of CRF stages: uremia period>kidney failure stage>renal decompensation stage>kidney compensatory period, compared between groups it was statistically significant (P<0.05). Using Pearson correlation analysis,levels of Scr, BUN were positively correlation respectively for CysC, Hcy and PTH levels in the research group,(r=0.73, 0.64, 0.81, P<0.05; r=0.68, 0.75, 0.83, P<0.05).Conclusion:The CysC, Hcy and PTH levels can reflect the clinical therapeutic effect and the severity of the disease in patients with CRF, meanwhile they can provide reference for the diagnosis and prognosis of patients with CRF, which has the high clinical significance.