血清胱抑素C浓度测定对病毒性脑炎患儿肾功能损害的诊断价值

Diagnostic value of serum Cystatin C in renal function impairments in children with viral encephalitis

摘要:

目的：探讨血清胱抑素C(Cyst C)浓度在评估病毒性脑炎患儿肾小球滤过功能中的价值。方法：92例病毒性脑炎患儿为病例组，50例健康儿童为对照组，又根据肾小球滤过率（GFR）将病例组分成肾功能正常组、代偿组、失代偿组和衰竭及终末期组。检测各组血清Cyst C、尿素氮(BUN)、肌酐(Cr)浓度。结果：① 与对照组比较，病例组BUN、Cr及Cyst C均显著增高(P0.05），在其余各病例亚组间差异有统计学意义（P<0.01）。③Cyst C与BUN、Cr呈显著正相关，与GFR呈显著负相关。结论：病毒性脑炎患儿存在不同程度的肾功能损害；Cyst C是一种比BUN和Cr更好地反映肾小球滤过功能的指标，检测血清Cyst C对病毒性脑炎患儿肾脏功能的监测有重要的临床应用价值。

Abstract:

OBJECTIVE: To study the value of serum Cystatin C (Cyst C) in the evaluation of glomerular filtration function in children with viral encephalitis. METHODS: Serum levels of Cyst C, urea nitrogen (BUN) and creatinine (Cr) were measured in 92 children with viral encephalitis and in 50 healthy children as a control group. According to glomerular filtration rate (GFR), the encephalitis group was subdivided into normal renal function, renal insufficiency in the compensatory or decompensatory stage, and renal failure /end-stage groups. RESULTS: Serum levels of Cyst C, BUN and Cr in the encephalitis group increased and GFR decreased significantly compared with those in the control group (P<0.01). With the decline of renal function, GFR decreased and serum levels of Cyst C, BUN and Cr increased gradually. Serum levels of Cyst C and GFR were significantly different among the encephaitis subgroups (P<0.01). For serum levels of BUN and Cr, there were significant differences among the subgroups except between the normal renal function and the compensatory renal insufficiency groups. Serum Cyst C level was positively correlated with serum BUN and Cr levels, and negatively correlated with GFR. CONCLUSIONS: The children with viral encephalitis have different degrees of renal impairments. Cyst C appears to be superior to BUN and Cr as a marker for the evaluation of glomerular filtration function. Measurement of serum Cyst C levels is very valuable in renal function monitoring in children with viral encephalitis.