【摘要】 目的:探讨血清胱抑素C（CysC）、尿微量白蛋白（mAlb）及β₂-微球蛋白（β₂-MG）检测对急性肾损伤（AKI）病人病情及预后判断的意义。方法:AKI病人97例根据AKI分期分成AKI1期组45例,AKI2期组27例,AKI3期组25例,同时选取同期55名健康体检者作为对照组。对各组血清CysC、尿mAlb及β₂-MG进行检测,同时对各组进行急性生理与慢性健康评估Ⅱ（APACHEⅡ）评分。结果:4组的血清CysC、尿mAlb、尿β₂-MG水平差异有统计学意义（P<0.01）,AKI各组的血清CysC、尿mAlb、尿β₂-MG水平均明显高于对照组（P<0.01）,AKI2组及AKI3组均明显高于AKI1组（P<0.01）,AKI3组明显高于AKI2组（P<0.01）。AKI各组APACHEⅡ评分差异有统计学意义（P<0.01）,AKI2组及AKI3组均明显高于AKI1组（P<0.01）,AKI3组明显高于AKI2组（P<0.01）;血清CysC、尿mAlb、尿β₂-MG水平与APACHEⅡ评分均存在显著正相关关系（P<0.01）;血清CysC、尿mAlb、尿β₂-MG联合检测AKI阳性检出率明显高于这3项指标单独检测时的阳性检出率（P<0.05）;AKI病人中存活组病人的血清CysC、尿mAlb、尿β₂-MG水平及APACHEⅡ评分均明显低于死亡组（P<0.01）。结论:血清CysC、尿mAlb及β₂-MG与AKI病人的病情严重程度及预后密切相关,可作为AKI病人病情及预后评估的重要指标。更多还原

【Abstract】 Objective: To investigate the significance of the serum cystatin C（ Cys C）,microdose albumin（ m Alb） and β₂-microglobulin（ β₂-MG） detection in the diagnosis and prognosis of the acute kidney injury（ AKI）. Methods: Ninety-seven AKI patients were divided into the stage AKI 1（ 45 cases）,stage AKI 2（ 27 cases） and stage AKI 3（ 25 cases）,and 55 healthy people were set as the control group. The levels of Cys C,m Alb and β₂-MG were detected in each group,and the scores of acute physiology and chronic health evaluation Ⅱ（ APACHEⅡ） in all cases were evaluated. Results: The differences of the serum levels of Cys C,m Alb and urineβ₂-MG between fours groups were statistically significant（ P < 0. 01）,the levels of Cys C,m Alb and urine β₂-MG in AKI groups were significantly higher than those in control group（ P < 0. 01）,the levels of Cys C,m Alb and urine β₂-MG in AKI 2 and AKI 3 groups were significantly higher than those in AKI 1 group（ P < 0. 01）,and the levels of Cys C,m Alb and urine β₂-MG in AKI 3 groups were significantly higher than those in AKI 2 group（ P < 0. 01）. The differences of the scores of APACHE Ⅱ between four groups were statistically significant（ P < 0. 01）,the scores of APACHEⅡ in AKI 2 and AKI 3 groups were significantly higher than those in AKI 1group（ P < 0. 01）,and the score of APACHEⅡ in AKI 3 group was significantly higher than that in AKI 2 group（ P < 0. 01）. The levels of serum Cys C,m Alb and urine β₂-MG were significantly positive correlated with APACHEⅡ score（ P < 0. 01）. The positive rate of the combined detection of serum Cys C,m Alb and β₂-MG in the diagnosis of AKI was significantly higher than that of the independent 3indicator（ P < 0. 05）. The levels of serum Cys C,m Alb,urine β₂-MG and APACHEⅡ score in survival cases were significantly lower than those in death cases（ P < 0. 01）. Conclusions: The serum Cys C,m Alb and urine β₂-MG are closely related to the severity and prognosis of AKI patients,which can be used as an important indicator in evaluating the severity and prognosis of AKI patients.更多还原