【摘要】 目的 探讨经皮冠状动脉介入治疗前后测定血清胱抑素C,经Stevens-Cr方程估算肾小球滤过率对早期诊断造影剂肾病的临床意义。方法 选取2014年1~8月在我院行PCI的患者256例,其中22例术后出现造影剂肾病,设为CIN组,其余234例患者设为对照组。分别于术前及术后12 h、24 h、48 h检测血肌酐、血清胱抑素C,经简化MDRD方程、Stevens-Cr方程估算肾小球滤过率,并进行比较。结果 术前CIN组肌酐、血清胱抑素C,经简化MDRD方程、Stevens-Cr方程估算出的肾小球滤过率与对照组相比未见统计学差异(P>0.05)。术后24 h CIN组患者血肌酐水平开始升高,经简化MDRD方程估算出的肾小球滤过率减低明显,与术前及对照组相比差异有统计学意义(P<0.01)。术后12 h CIN组患者血清胱抑素C水平开始升高,经Stevens-Cr方程估算出的肾小球滤过率减低明显,与术前及对照组相比差异有统计学意义(P<0.05)。结论 血清胱抑素C、经Stevens-Cr方程估算出的肾小球滤过率可以反映早期肾功能损害的严重程度,可以作为造影剂肾病的检测指标。更多还原

【Abstract】 Objective To study the significance of joint detection of cystatin C(Cys C) and glomerular filtration rate(eGFR) calculated by Stevens-Cr equation in early diagnosis of contrast-induced nephropathy(CIN)after percutaneous coronary intervention(PCI).Methods In 256 patients undergoing PCI,22 patients had CIN(CIN group) and 234 patients had no CIN(control group).Serum creatinine(Scr),Cys C were detected before and12 hours,24 hours and 48 hours after PCI.eGFR were calculated by simplified MDRD equation and Stevens-Cr Equation respectively.Results There were no significant differences in Scr,Cys C and eGFR levels before PCI between CIN group and control group(P>0.05).The levels of Scr and eGFR calculated by simplified MDRD equation were significantly higher in CIN group than those in control group 24 hours after PCI(P<0.01),and were significantly higher than those before PCI in CIN group(P<0.01).The levels of Cys C and eGFR calculated by Stevens-Cr equation were significantly higher in CIN group than those in control group 12 hours after PCI(P<0.05),and were significantly higher than those before PCI in CIN group(P<0.05).Conclusion Cys C and eGFR calculated by Stevens-Cr equation can be a reliable indicator for early impairment of renal function,and will be helpful for diagnosis of CIN.更多还原