胱蛋白酶抑制剂C与肌酐评价儿童肾小球滤过功能中的作用比较

用胱蛋白酶抑制剂C与肌酐、内生肌酐清除率评价儿童肾小球滤过功能,并将其作用进行比较,确定胱蛋白酶抑制剂C在儿童中的正常参考范围。采用颗粒增强散射免疫比浊法检测150例出生后2d～13岁正常儿童及90例1～16岁患不同程度肾脏疾病的儿童血清中胱蛋白酶抑制剂C和血肌酐的浓度,并比较胱蛋白酶抑制剂C与血肌酐的相关性。结果发现胱蛋白酶抑制剂C在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范围。血清胱蛋白酶抑制剂浓度C与尿素清除率之间有显著相关性(P<0.01)。此外,在内生肌酐清除率CCr>80(属于正常参考范围)的肾脏疾病的患儿中有56%胱蛋白酶抑制剂C异常,说明胱蛋白酶抑制剂C比血肌酐更能够敏感地反应儿童肾小球滤过功能的损伤,建议用胱蛋白酶抑制剂C作为儿童肾脏疾病的患者肾小球滤过功能的损伤指标。

Comparison of the effects between cystatin C and creatinine in evaluating glomerular filtration function of children

The glomerular filtration function of children were evaluated with cystatin C,creatinine and endogenous creatinine clearance rate(CCr),and made a comparison between their effects.The normal range of cystatin C was established in children.150 cases of health children(2 days to 13 years old) and 90 cases of children(1-16 years old) with the kidney disease were selected.Their cystatin C concentration and createnine concentration in serum were detected by particle-enhanced nephelometric immunoassay(PENIA) and made a comparison between their relativity.The results showed that the level of cystatin C in children(>four months) is higher than that of adults,but when they are above five months the level drops to the normal value of adults.The concentration of cystatin C is highly related to extinguishing rate of urea(P<0.001).The concentration of serum cystain C is abnormall in 56 percent of children with kidney diseases though their CCr is higer than 80.Cystain C is more sensitive that Scr in reflecting the damage degree of the filtration function of glomerulus of children with kidney disease.