摘要
目的:探讨血清胱抑素C在重症患者合并急性肾损伤早期诊断中的价值。方法:对46例危重患者(观察组)及71例正常体检者(对照组),采用酶法测血清肌酐水平,酶联免疫吸附法测血清胱抑素C水平,采用ROC评价血清胱抑素C的诊断价值,应用Cockroft-Gault公式估算肾小球滤过率。结果:观察组1,2,3期患者分别为19,11和16例;血清胱抑素C较对照组明显升高(P<0.01);观察组血清胱抑素C与血清肌酐呈明显线性相关(r=0.877,P<0.01),血清胱抑素C倒数与估算肾小球滤过率呈明显线性相关(r=0.924,P<0.01)。ROC得出血清胱抑素C最佳截断值为1.832 mg/L,血清肌酐最佳截断值为123.5μmol/L,血清胱抑素C在急性肾损伤诊断中准确性、阳性预测值、阴性预测值均较血清肌酐高(P<0.01)。急性肾损伤1期患者血清胱抑素C灵敏度(89.5%)明显高于血清肌酐灵敏度(57.9%)(P<0.05),急性肾损伤2、3期患者间灵敏度比较差异无统计学意义(P>0.05)。结论:重症患者血清胱抑素C可作为急性肾损伤肾小球滤过率的内源性标志物,对急性肾损伤患者早期诊断有重要作用。
Objective To study the value of cystatin C to the early diagnosis of acute kidney injury in the critical patients.Methods A total of 46 critical patients with acute kidney injury（abservation group） and 71 healthy controls（control group） were measured the serum creatinine with enzymic method,were detected cystatin C with ELISA and were estimated glomemlar filtration rate with Cockrofi-Gault equation.The diagnostic value of cystatin C was calculated with ROC.All data were analyzed by using of statistical software of SPSS13.0.Results In the abservation group,there were 19,11 and 16 patients in stages 1,2 and 3 of acute kidney injury.In patients with acute kidney injury,serum cystatin C was significantly higher in the abservation group than that in control group（P0.01）.Serum cystatin C was linearly correlated with serum creatinine（r=0.877,P0.01）,and（cystatin C）-1 was linearly correlated with estimated glomerular filtration rate（r=0.924,P0.01）.The cutoff of cystatin C was 1.832 mg/L and serum creatinine was 123.5 μmol/L.The accuracy as well as the positive and negative preditive values of cystatin C were higher than those of serum creatinine in diagnosing acute kidney injury（P0.01）.The sensitivity of cystatin C（89.5%） was obviously higher than that of serum creatinine（57.9%） in stage 1 patients（P0.05）.There were no significant differences in the sensitivities between stage 2 and stage 3 patients（P0.05）.Conclusion Serum cystatin C can be one of the endogenous markers for glomerular filtration rate in the critical patients with acute kidney injury,and it can show acute kidney injury much earlier than serum creatinine.
出处
《中华实用诊断与治疗杂志》
2011年第7期653-655,共3页
Journal of Chinese Practical Diagnosis and Therapy
关键词
急性肾损伤
血清胱抑素C
肾小球滤过率
早期诊断
Acute kidney injury
serum cystatin C
glomerular filtration rate
early diagnosis
