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1、胱抑素・c在含钳方案化疗患者肾功能评价中的地位蒋敏1卓玛1陆超2徐建忠(通讯作者)1(1苏州大学附属常州肿瘤医院肿瘤内科八病区213001)(2苏州大学附属常州肿瘤医院临床药学室213001)【摘要】目的评价胱抑素C(CysC)用于监测化疗药物导致恶性肿瘤患者肾功能损害的可行性和可靠性。方法检测30例晚期恶性肿瘤患者化疗前后血清肌肝(Cr)、胱抑素C(CysC)和内生肌酹清除率(Ccr)等指标，分析CysC表达水平与患者性别、年龄的关系;探讨血清中CysC和Cr的表达水平在化疗前后是否存在差异，并观察血C
2、ysC和Cr、Ccr之间的关系。结果CysC的表达水平在不同年龄组(大于60岁和小于60岁)及不同性别组，差异无统计学意义；血CysC与Cr之间呈正相关(r=0.431,P=0.01);血Cr与Ccr呈负相关(r=-0.628,P<0.01);血CysC与Ccr呈负相关(r=-0.410,P<0.05),CysC与Ccr的相关性不如Cr(r=-0.410vsr=-0.628,P>0.05)。患者化疗后血CysC值高于化疗前(P<0.01)，其中13例患者接受含顺钳方案化疗，化疗后CysC值较化疗前增加(P
3、<0.01);17例患者接受含草酸钳、奥沙利钳或奈达钳方案化疗，化疗后血CysC值亦较化疗前增加(P<0.01)o两组患者化疗后血Cr水平变化差异无统计学意义(P>0.05)o结论含钳方案化疗时，血CysC能用于检测肾功能变化，但尚不能替代Cr。【关键词】恶性肿瘤钳类肾毒性胱抑素・C肌肝【中图分类号】R96【文献标识码】A【文章编号】1672-5085(2013)32-0048-02DetectionofSerumCystatinCintherenalimpairmentinpatientsreceivi
4、ngchemotherapywithplatinumcontainingregimensJiangMinZhuoMaLuChaoXuJianzhongl.DepartmentOfOncology,AffiliatedChangzhouTumorHosptal,SuzhouUniversityChangz-hou213001.2.ClinicalPharmacydepartmentofPharmacy,ChangzhouCancerHospital,AffiliatedofSoochowUniversity
5、,Changzhou213001.[Abstract]Objective:ToevaluatetheapplicabilityandthefeasibilityofserumcystatinC(CysC)asaendogenousmarkerfordetectionofchemotherapy——inducedrenaldisfunctioninpatientswithmalignanttumors.Methods：For30patients,todetectthelevelsofserumcreatin
6、ineandCysC,calculatethecreatinineclearance(Ccr)byCockcroftGaultequation,thenanalyzewhethertherearedifferencesforCysCingender,ageperformaneestatus,whethertherearedifferencesforCysCandserumcreatininebeforeandafterchemotherapy・Thecorrelationbetweenthemwasals
7、oobserved.Results:ForCysC,therearenodifferencesinageandgenderperformaneestatus;ThecorrelationbetweenserumCrandCystatinCwasconfirmed(r=0.431,P=0.01);CystatinCwascorrelatedwithcreatininesignificantly(r=-0.410,P<0.05),anditscorrelationwithCcrwasnobetterthanc
8、reatinine(r=-0.410vsr=-0.628,P>0.05);theserumCystatinClevelofthepatientswashigherafterchemotherapythanbefore(P<0.01).Thirteenpatientsreceivedchemotherapywithcisplatin,andtheirserumCystatinClevelsincreased(P<0.01);Se
