摘要
目的测定ICU的急性肾损伤(AKI)患者和ICU非AKI患者的血清胱抑素-C(CysC)、尿素、肌酐、尿酸及β2-MG的水平,研究CysC在AKI中的应用价值。方法采用日立7170全自动生化分析仪测定ICUAKI患者37例和ICU非AKI患者20例的CysC、尿素、肌酐、尿酸和β2-MG,用受试者工作曲线评价CysC的诊断价值,采用SPSS16.0统计软件包进行统计分析。结果ICU的AKI患者的血清CysC水平较ICU非AKI对照组升高,有统计学意义,且与尿素、肌酐、尿酸和β2-MG成正相关,相关系数分别为r=0.516,P<0.01、r=0.552,P<0.01、r=0.569,P<0.01、r=0.360,P<0.05;1/CysC与eGFR呈正相关,r=0.733,P<0.001;与AKI分期差异无统计学意义。ROC曲线分析证实CysC在AKI的诊断中敏感性和特异性最好。结论血清CysC可以做为ICU病人发生AKI的诊断指标,为AKI的及时诊断、肾功能的评估提供了可靠的依据,有助于临床更好的把握治疗时机。
[Objective] To explore the applied value of Cystatin C （Cys C） in acute kidney injury （AKI）with the detection of Cys C, UN, Scr ,UA and β2-MG in ICU AKI patients and ICU non-AKI patients. [Methods] In this study, 57 patients were collected. They were divided into two groups, including 37 cases with AKI and 20 cases without AKI as controls. We measured the serum levels of Cys C, β2-MG, UN, UA and Ser by the Laboratory professionals by Hitachi 7170A Automatic biochemical analyzer. We estimated the eGFR with MDRD equation. Then we compared the levels of Cys C, UN, Ser, UA and β2-MG between two groups, the levels of Cys C among AKI groups, and their correlations with each other. Using ROC curve evaluate the diagnostic value of Cys C. All analysis was performed by SPSS 16.0 software. [Results] The serum level of Cys C were significantly higher in AKI group than in non-AKI group （P 〈0.05）, but in AKI group it was no significant difference among three periods （P 〉0.05）. The serum level of Cys C was positively correlated with UN, Scr, UA and β2-MG （r =0.516, P 〈0.01; r =0.552, P 〈 0.01; r =0.360, P 〈0.05; r =0.569, P 〈0.01）, and 1/Cys C was also positively correlated with eGFR （r =0.733, P 〈 0.001）. The ROCAUR of Cys C is 0.932, it＇s the best. [Conclusions] The study shows that Cys C can become a diagnostic indicator in AKI, and can diagnose AKI timely, provide a reliable assessment of renal function and grasp the right opportunity to better treatment.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2009年第11期1705-1709,1712,共6页
China Journal of Modern Medicine
