摘要
目的观察血胱抑素C（cysC）在不同程度急性。肾损伤（AKI）及终末期肾病（ESRD）患者血清中的浓度变化，探讨其对AKI的早期诊断价值及其与肾功能损伤程度的相关性。方法搜集ICUAKI患者，“5．12”汶川地震伤员，ESRD患者及健康对照者的血清、尿液及临床表现等资料；按照RIFLE标准，分为轻度AKI组20例、中重度AKI组30例，另外，地震外伤组48例、ESRD组32例和健康对照组20例；采用微粒子增强免疫比浊法检测血清cysC，比色法检测尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG酶），酶法检测血肌酐（Scr）；对血cysC与Scr的相关性进行统计学分析，并绘制受试者工作特征曲线（ROC曲线），评价血cysC在AKI早期诊断中的敏感性和特异性及其与肾功能损伤程度的相关性。结果与健康对照组比较，轻度AKI组、中重度AKI组和ESRD组血cysC均有明显升高（P〈0．05或P〈0．01），其中ESRD组升高更明显（P〈0．01）；血cysC与Scr呈正相关关系（P〈0．01）；地震外伤组血清cysC较健康对照组升高（P〈0．05），且血cysC在AKI诊断中的ROC曲线下面积为0．931（P〈0．01）。结论AKI发生时检测血cysC有助于AKI的早期临床诊断；血cysC与肾功能损伤程度呈正相关关系，能准确反应肾功能变化。
Objectives To investigate the changes of cystatin C in the serum of patients with acute kidney injury （ AKI ） or end-stage renal disease （ ESRD ） , and study its significance in the early diagnosis of AKI and its correlation with the degree of renal function injury. Method The cases in Xiangya hospital were enrolled in this study according to the RIFLE criteria, including 20 cases of slight acute kidney injury, 30 cases of medium-severe acute kidney injury, 48 cases of victims of the 5.12 wenehuan earthquake, 32 cases of end-stage renal disease and 20 healthy patients. The microparticle-enhanced immunoturbidimetry method was used to detect serum cystatin C, and the colorimetric method was used to detect urine N-acetylbeta-D-glucosaminidase （NAGase）. The enzymic method was used to detect serum creatinine. The correla- tion between serum cystatin C and serum creatinine was analyzed, and the sensitivity and specificity of serum cystatin C were evaluated with the receiver operator characteristic curve （ROC curve）. Results Compared with healthy control group, the serum cystatin C increased obviously in acute kidney injury group and ESRD group（ P 〈0. 05 andP 〈0. 01 ）. The serum cystatin C was positively correlated with serum creatinine（ P 〈0. 01 ）. The serum cystatin C in the 5.12 wenchuan earthquake injured group was also higher than that in healthy control group（ P 〈0. 05）, and the serum cystatin C had an AUC -ROC of 0. 931 （ P 〈 0. 01 ）. Conclusion Compared to the conventional biomarkers, the earlier emergence of serum cystatin C can contribute better to early clinical diagnosis of AKI. The serum cystatin C is positively correlated with renal function, and reflect changes in renal function accurately.
出处
《中国医师杂志》
CAS
2010年第1期35-38,共4页
Journal of Chinese Physician
