血清Cys C的检测对肾移植术后患者肾功能评价的临床意义

探讨分析血清胱抑素C（Cys C）水平在肾移植术后患者肾功能监测中的应用价值.对25例肾移植成功患者在术前、术后第1、3、5、7、10天的血清Cys C、Scr、β2-MG、BUN水平进行动态监测,同时随机抽取健康体检者中的20例作为对照组.发现移植组的Cys C、Scr、β2-MG、BUN水平在术前均明显高于健康对照组（P＜0.01）.这四项指标在手术后第一天都有所下降,且术后第1、3、5、7、10天的水平都比术前低（P＜0.01）.四项指标与GFR的关系均为显著性负相关（P＜0.01）,其中血清Cys C与GFR的相关性最好.Cys C、Scr、β2-MG、BUN检测后的ROC曲线下面积分别是：0.937、0.838、0.798、0.772,其差异都具有统计学意义（P＜0.05）.血清Cys C优于Scr、β2-MG、BUN,在肾移植患者术后的动态监测中具有重要的临床应用价值.

Clinical Significance of Determination of Serum Cys C in Evaluation of Renal Function in Patients after Renal Transplantation

To investigate and analyze applied value of serum cystatin C（Cys C） in patients after transplantation.The serum levels of Cys C,serum creatinine（Scr）,β2-Microglobulin（β2-MG） and urea nitrogen （BUN） are dynamically measured before and after operation in first,3th,5th,7th and 10th days for 25 patients.Meanwhile,the authors randomly selected twenty healthy subjects as normal control group.The Cys C,Scr,β2-MG,BUN levels of transplantation group are higher than those in healthy control group before operation （P＜0.01）.Four indexes are decreased in the first day after operation and they are lower than that of the preoperative level after operation in first,3th,5th,7th and 10th days （P＜0.01）.The relationship between four indexes and GFR are significantly negative correlation （P＜0.01）,the best correlation is between serum Cys C and GFR.Areas of ROC curve of Cys C,Scr,β2-MG,BUN are：0.937,0.838,0.798,0.774,respectively.All of the differences are significant （P＜0.05）.Serum Cys C is better than Scr,β2-MG,BUN.And it has important clinical application value in dynamic monitoring for patients after renal transplantation.