摘要
目的探讨血清胱抑素C（CystatinC）在危重患儿急性肾损伤（AKI）早期诊断中的价值。方法收集重症监护病房中的危重患儿98例，根据是否发生AKI分为AKI组和非AKI组。每日采集血液标本，用免疫比浊法检测两组间CystatinC浓度，用苦味酸法检测两组间血清肌酐（SCr）浓度。比较二者变化的相关性，及在AKI各期诊断的中位时间值的差异。结果98例危重患儿中33例发生AKI，65例未发生AKI。AKI组患儿血清SCr[（209．21±100．53）μmol／L]和CystatinC[（2．68±0．86）mg／L]较非AKI组患儿[（77．46±8．11）μmol／L和（0．76±0．15）mg／L]显著升高，差异有统计学意义（t值分别为10．55、17．56，P均〈0．001）；且二者变化一致，呈正相关（r=0．874，P〈0．001）。CystatinC在AKI分期I期、Ⅱ期和Ⅲ期的平均诊断时间分别为（3．0±2．5）、（5．0±3．0）、（9．0±4．0）d，较SCr（（5．0±2．0）、（7．0±2．5）、（10．0±3．0）d）明显提前，差异有统计学意义（t值分别为4．39、2．29、3．16，P〈0．01或P〈0．05）。结论在AKI发生过程中，GystatinC浓度升高较SCr早，因此CystatinC可作为危重患儿AKI早期预测指标之一。
Objective To investigate the early diagnostic value of serum Cystatin C in the diagnosis of acute kidney injury （AKI） in critically ill children. Methods Ninety-eight children of the severe case patients＇ rooms were divided into two groups ：33 cases were AKI,65 cases were NAKI. Cystatin C and SCr in blood serum were detected by immunoturbidimetry and enzymic method every day. And compared serum Cystatin C, SCr concentrate and median diagnosis time between the two groups. Results Thirty-three cases in 98 cases of critically ill children occurred the AKI,65 patients without AKI. Comparing with the NAKI,the Cystatin C of AKI patients were significantly higher （ （2. 68 ±0. 86） mg/L vs （0.76 ±0. 15） mg/L） and SCr （ （209. 21± 100. 53 ） μmol/L vs （77.46 ±8. 11 ） trmol/L）, the differences were statistically significant （ t = 10.55,17. 56, P 〈 0. 001 ） ; Cystatin C was in positive correlation with SCr （ r = 0. 874, P 〈 0. 001 ） ; Median diagnosis time of AKII , II, and HI stage with Cystatin C were （ 3.0±2. 5 ） d, （5.0 ± 3.0） d and （9. 0±4.0） d, respectively, which was earlier than that of SCr （ （ 5.0 ±2. 0 ） d, （ 7.0 ± 2. 5 ） d and （ 10. 0 ± 3.0 ） d, respectively ; t = 4. 39, 2. 29,3.16, respectively ;P 〈 0. 01 or P 〈 0. 05 ）. Conclusion In the process of AKI, the level of serum Cystatin C elevated significantly earlier than SCr, so it could as be one of the early dynamic criteria in the critically ill children.
出处
《中国综合临床》
2013年第6期574-576,共3页
Clinical Medicine of China
基金
广东省科技计划项目（2011B031800374）
关键词
胱抑素C
血清肌酐
急性肾损伤
Cystatin C
Serum creatinine
Acute kidney injury
