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RESUME Titre : Applications cliniques de la cystatine C

Dans le document Applications cliniques de la cystatine C (Page 109-144)

Auteur : ALAMI Yousra

Mots clés : Cystatine C; pathologies rénales; pathologies tumorales; pathologies neurologiques.

En pratique clinique, la cystatine C est connue comme un biomarqueur de la fonction rénale glomérulaire et contrairement à la créatinine, elle est moins dépendante de l'âge, du sexe, de la race, de la masse musculaire ou de tout processus inflammatoire. Sa détermination reste cependant réservée à des indications de seconde intention: appréciation plus précise de DFG, interférence analytique avec la technique de dosage de la créatinine, évaluation de la fonction rénale de patients présentant une réduction de la masse musculaire.

D’autres applications de la cystatine C ont été étudiées: ajustement de la posologie des médicaments néphrotoxiques tel que les anticancéreux, facteur de risque des maladies cardiovasculaires, aide au diagnostic de pathologies neurologiques telle que la maladie d’Alzheimer et l’angiopathie amyloïde cérébrale à cystatine C.

La standarisation récente du dosage de la cystatine C permettrait son utilisation dans de grandes séries d’études randomisées et par conséquent la validation de ses indications cliniques.

SUMMARY

Title:Clinical applications of cystatin C Author: ALAMI Yousra

Keywords: Cystatin C;kidney Diseases; tumor diseases; neurological diseases.

In clinical practice, cystatin C is known as a biomarker of glomerular renal function and unlike creatinine, it is less dependent on age, sex, race, muscle mass or any inflammatory process. However, its determination remains reserved for second-line indications: more precise evaluation of DFG, analytical interference with the creatinine assay technique, the renal function evaluation of patients with muscle mass reduction.

Other applications of cystatin C have been studied: dosage adjustment of nephrotoxic drugs such as anticancer drugs, risk factor of cardiovascular diseases, aid in the diagnosis of neurological pathologies such as Alzheimer's disease and cerebral amyloid angiopathy at cystatin C.

The recent standardization of the cystatin C assay would allow its use in large series of randomized studies and consequently the validation of its clinical indications.

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ناﻮﻨﻌﻟا : ﺔﯾﺮﯾﺮﺴﻟا تﺎﻘﯿﺒﻄﺘﻟا ﻦﯿﺗﺎﺘﺴﯿﺴﻠﻟ س . ﺐﺗﺎﻜﻟا : ىﺮﺴﯾ ﻲﻤﻠﻌﻟا ﺔﯿﺳﺎﺳﻷا تﺎﻤﻠﻜﻟا : ;.س ﻦﯿﺗﺎﺘﺴﯿﺴﻟا ضاﺮﻣأ ﻰﻠﻜﻟا ; ضاﺮﻣﻷا ﺔﯿﻧﺎطﺮﺴﻟا ; ضاﺮﻣﻷا .ﺔﯿﺒﺼﻌﻟا ﺲ ﻜﻋو ,ﻲ ﺒﯿﺒﻜﻟا ﻲ ﻠﻜﻟا ﻒﺋﺎ ظﻮﻟ ﺔ ﯿﺟﻮﻟﻮﯿﺑ ﺔ ﻣﻼﻌﻛ .س ﻦﯿﺗﺎﺘ ﺴﯿﺴﻟا فﺮ ﻌﺗ ,ﺔﯾﺮﯾﺮ ﺴﻟا ﺔ ﺳرﺎﻤﻤﻟا ﻲﻓ ﻦﯿﻨﺗﺎ ﯾﺮﻜﻟا ، ا ﺔ ﻠﺘﻜﻟاو قﺮ ﻌﻟاو ﺲﻨﺠﻟﺎ ﺑ ﺎ طﺎﺒﺗرا ﻞ ﻗأ ﻲ ﮭﻓ ﻢ ﺗ ﻦ ﻣو. بﺎ ﮭﺘﻟﻻا ﺔ ﯿﻠﻤﻋ يأو ﺔﯿﻠ ﻀﻌﻟ ﻰ ﻘﺒﯾ ﺔﯾﻮﻧﺎﺜﻟا تﻻﺎﻤﻌﺘﺳﻹا ﻲﻓ ادوﺪﺤﻣ ﺎﮭﻣاﺪﺨﺘﺳا : ﻞﺧاﺪ ﺘﻟا دﻮ ﺟو ﺪ ﻨﻋو ﻲ ﺒﯿﺒﻜﻟا ﺢﯿ ﺷﺮﺘﻟا لﺪ ﻌﻤﻟ ﺔ ﻗد ﺮ ﺜﻛأ ﻢﯿ ﯿﻘﺗ ﺔ ﻠﺘﻜﻟا ﻲ ﻓ ضﺎﻔﺨﻧا ﻦﻣ نﻮﻧﺎﻌﯾ ﻦﯾﺬﻟا ﻰﺿﺮﻤﻟا ﺪﻨﻋ ﻲﻠﻜﻟا ﺔﻔﯿظو ﻢﯿﯿﻘﺗو ﻦﯿﻨﺗﺎﯾﺮﻜﻟا ةﺮﯾﺎﻌﻣ ﺔﯿﻨﻘﺗ ﻊﻣ ﻲﻠﯿﻠﺤﺘﻟا .ﺔﯿﻠﻀﻌﻟا ارد ﺖﻤﺗ ﺎﻤﻛ .س ﻦﯿﺗﺎﺘ ﺴﯿﺴﻠﻟ ىﺮ ﺧأ تﺎ ﻘﯿﺒﻄﺗ ﺔ ﺳ : ﻰ ﻠﻋ ﻲﺒﻠ ﺳ ﺮﯿﺛﺄ ﺗ ﺎ ﮭﻟ ﻲ ﺘﻟا ﺔ ﯾودﻷا ﺔ ﻋﺮﺟ ﻞﯾﺪ ﻌﺗ لﺎ ﻤﺘﺣا, نﺎطﺮ ﺴﻟا تادﺎ ﻀﻣ ﻞ ﺜﻣ ﻲ ﻠﻜﻟا ﺔﺑﺎ ﺻﻹا ﺺﯿﺨ ﺸﺗ ﻰ ﻠﻋ ةﺪﻋﺎ ﺴﻤﻟاو ﻦﯿﯾاﺮ ﺸﻟاو ﺐ ﻠﻘﻟا ضاﺮﻣﺄ ﺑ و ﺮﻤﯾﺎھﺰﻟا ضﺮﻣ ﻞﺜﻣ ﺔﯿﺒﺼﻌﻟا ضاﺮﻣﻷا لﻼﺘﻋا ﻷا ﺔﯿﻋو ﺔﯿﻏﺎﻣﺪﻟا .ﺔﯿﻧاﻮﺸﻨﻟا ةﺮﯾﺎ ﻌﻤﻟ ﺮ ﯿﺧﻷا ﺪ ﯿﺣﻮﺘﻟا ﻦﻜﻤﯿ ﺳ س ﻦﯿﺗﺎﺘ ﺴﯿﺴﻟا تﺎ ﺳارﺪﻟا ﻦ ﻣ ﺔﻌ ﺳاو ﺔﻠ ﺴﻠﺳ ﻲ ﻓ ﺎﮭﻟﺎﻤﻌﺘ ﺳا ﻦ ﻣ . ﺔﯿﺋاﻮﺸﻌﻟا ، ﺔﯾﺮﯾﺮﺴﻟا ﺎﮭﺗﻻﺎﻤﻌﺘﺳا ﺪﯿﻛﺄﺗ ﻲﻟﺎﺘﻟﺎﺑو

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