内科

目的探讨慢性阻塞性肺疾病（COPD）合并早期肾功能损害患者血清胱抑素C（Cystatin C）、同型半胱氨酸（Hcy）、C反应蛋白（CRP）含量的变化及相关性。方法选择COPD患者150例，根据检查结果，将未合并肾功能损害的患者50例设为肾功能正常组；将COPD合并肾功能损害Ⅰ期患者50例设为肾功能Ⅰ期组；将COPD合并肾功能损害Ⅱ期患者50例设为肾功能Ⅱ期组。检测比较三组患者血肌酐（Scr）和尿素氮（Urea）水平以及血清Cystatin C、Hcy、CRP含量；对Cystatin C、Hcy与CRP的关系进行相关性分析。结果三组患者的血肌酐、血尿素氮水平比较差异无统计学意义（P＞0.05）。肾功能Ⅰ期组、Ⅱ期组患者血清Cystatin C、Hcy、CRP含量高于肾功能正常组（P＜0.05），肾功能Ⅱ期组患者各指标水平高于肾功能Ⅰ期组（P＜0.05）。患者血清Cystatin C含量、Hcy含量与CRP含量呈正相关（r=0.840，r=0.333）。结论与肾功能正常的患者比较，COPD合并肾功能损害患者血清Cystatin C、Hcy、CRP含量明显升高，Cystatin C、Hcy含量与CRP含量呈正相关，CRP含量可以早期反映出患者肾功能变化，可能可作为判断COPD患者早期肾功能损害的指标。

ObjectiveTo investigate the changes of serum Cystatin C, Hcy and CRP in patients with chronic obstructive pulmonary disease (COPD ) complicated with early renal impairment and the correlation among the three. MethodsA total of 150 patients with COPD were enrolled and divided into normal group (patients without renal damage, n=50), renal function stage Ⅰ group (patients in renal function stage Ⅰ,n=50) and renal function stage Ⅱ group (patients in renal function stage Ⅱ n=50) according to the examination results. The level of serum Cystatin C, Hcy and CRP were detected, and the relationship of Cystatin C, Hcy and CRP was analyzed. ResultsThere was no statistical difference in the level of serum creatinine and blood urea nitrogen among the three groups (P＞0.05). The level of Cystatin C, Hcy, CRP in the renal function stage Ⅰ group and renal function stage Ⅱ group were significantly higher than those in the normal group; and the indicators mentioned above in the renal function stage Ⅱ group were significantly higher than those in the renal function stage Ⅰ group (P＜0.05). The level of CRP was positively correlated with Cystatin C, Hcy(r=0.840 and r=0.333). ConclusionsCompared with patients without renal damage, the level of Cystatin C, Hcy and CRP increased significantly in patients with COPD complicated with renal impairment, the level of CRP was positively correlated with Cystatin C, Hcy, and it can evaluate the renal function at early stage of disease, which may be an index to estimate the early renal impairment in patients with COPD.