摘要
目的探究血清胱抑素C(CysC)、尿β2微球蛋白(β2-MG)、肝型脂肪酸结合蛋白(L-FABP)联合检测在心脏手术后急性肾损伤早期诊断中的价值。方法回顾性选择本院2015年4月至2016年8月期间行心脏手术患者126例为研究对象,根据术后是否发生急性肾损伤分为急性肾损伤(AKI)组48例,非急性肾损伤(非AKI)组78例,检测两组患者血清CysC、尿β2-MG、L-FABP水平,ROC曲线分析血清CysC、尿β2-MG、L-FABP对心脏手术后AKI的早期诊断价值。结果本组研究对象心脏手术后AKI发生率为38.10%(48/126);AKI组患者血清CysC水平显著高于非AKI组(P<0.05);尿β2-MG和L-FABP水平显著高于非AKI组(P<0.05);血清CysC对心脏手术后AKI诊断的AUC面积为0.874(P<0.05),诊断灵敏度为85.7%,特异度为76.5%;尿β2-MG对心脏手术后AKI诊断的AUC面积为0.754(P<0.05),诊断灵敏度为92.9%,特异度为73.5%;尿L-FABP对心脏手术后AKI诊断的AUC面积为0.834(P<0.05),诊断灵敏度为92.9%,特异度为74.1%。三者联合诊断的AUC面积为0.914(P<0.05),诊断灵敏度为92.1%,特异度为82.4%。结论血清CysC、尿β2-MG、L-FABP水平在AKI组患者中显著升高,三组单独诊断有一定的参考价值,但均低于联合诊断效能,三者联合诊断可为筛查心脏手术后急性肾损伤提供重要的参考。
Objective To explore the value of combined detection of serum cystatin C(CysC),urinary β2-microglobulin(β2-MG),and liver type fatty acid binding protein(L-FABP)in early diagnosis of acute renal injury after cardiac surgery.Methods 126 patients undergoing cardiac surgery in our hospital from April 2015 to August 2016 were selected as the subjects,according to the occurrence of acute renal injury after operation,48 cases were divided into acute renal injury(AKI)group and 78 cases into non-acute renal injury(non AKI)group,the levels of serum CysC,urine β2-MG,and L-FABP were detected in the two groups.Receiver operating characteristic(ROC)curve was used to analyze the effects of serum CysC,urine β2-MG,L-FABP in the early diagnosis of acute renal injury after cardiac surgery.Results The incidence of AKI after cardiac surgery was 38.10%(48/126);the serum CysC level in group AKI was significantly higher than that in non AKI group(P<0.05);the levels of urine β2-MG and L-FABP were significantly higher than those in non AKI group(P<0.05);the area under curve(AUC)of serum CysC for AKI diagnosis after cardiac surgery was 0.874(P<0.05),with diagnostic sensitivity 85.7%,and specificity 76.5%;the AUC area of urinary β2-MG for AKI diagnosis after cardiac surgery was 0.754(P<0.05),with diagnostic sensitivity 92.9%,and specificity 73.5%,respectively;the AUC area of urinary L-FABP for AKI diagnosis after cardiac surgery was 0.834(P<0.05),with diagnostic sensitivity 92.9%,and specificity 74.1%.The AUC area of combined diagnosis of the three was 0.914(P<0.05),with the diagnostic sensitivity 92.1%,and specificity 82.4%.Conclusions Serum CysC,urine β2-MG and LFABP levels were significantly increased in patients with AKI.The diagnosis of the three alone has a certain reference value,which is lower than the combined diagnosis.The combined diagnosis of the three can provide an important reference for screening acute renal injury after heart surgery.
作者
刘芳
薛林霞
Liu Fang;Xue Linxia(Department of Clinical Laboratory,the Second Affiliated Hospital of Xi'an Medical College,Xi'an 710038,China;Department of Neurology,the Second Affiliated Hospital of Xi'an Medical College,Xi'an 710038,China)
出处
《中国医师杂志》
CAS
2019年第12期1817-1820,1824,共5页
Journal of Chinese Physician
