【摘要】 目的胱抑素C(Cys-C)对脓毒症合并急性损伤(AKI)患者的诊断价值。方法选取2016年11月～2017年11月我院接收的100例脓毒症合并急性肾损伤患者作为观察组,同时选择同期在我院就诊的脓毒症患者100例作为对照组,均患者于入院2、24及48h时采集患者3mL静脉血检测Cys-C水平及血肌酐(Scr)水平,并计算肾小球滤过率(GFR),采用Pearson相关系数进行组间的相关性描述,采用ROC的灵敏性特异性对指标诊断价值进行判定。结果观察组患者入科24、48h时Scr水平明显高于对照组,而入院2h比较无明显差异,而Cys-C在上,两组患者入院2、24及48h比较差异均有统计学意义(P <0.05);CysC1-3与Scr1无相关性,Cys-C与Scr2-3呈正相关(均P <0.05);血清Scr、Cys-C与GFR均呈负相关(P<0.05),而Cys-C与GFR的相关系数较Scr与GFR的相关系数更高;观察组患者Scr1的ROC曲线下面积为0.5,其余时间点的Scr及Cys-C的ROC曲线下面积均在0.8以上。观察组入科2h Cys-C的AUC约为0.815,Cys-C的临界值为1.15mg/L,Scr的AUC值约为0.546,临界值为110μmol/L。结论脓毒症相关的急性肾损伤患者血Cys-C水平明显升高,较Scr可更早反映肾脏损伤,对于急性肾脏损伤的早期识别有重要意义。更多还原

【Abstract】 Objective To explore the diagnostic value of cystatin C(Cys-C) in patients with sepsis complicated with acute kidney injury(AKI). Methods 100 patients with sepsis complicated with acute kidney injury who were admitted to our hospital from November 2016 to November 2017 were selected as the observation group.100 patients with sepsis who were treated in our hospital during the same period were selected as the control group.At 2 h,24 h and 48 h after admission,3 mL of venous blood was collected to detect the level of Cys-C and serum creatinine(Scr),and the glomerular filtration rate(GFR)was calculated.Pearson correlation coefficient was used to describe the correlation between the groups,and the sensitivity and specificity of ROC were used to determine the diagnostic value of the indexes. Results The Scr level in the observation group was significantly higher than that in the control group at 24 h and 48 h after admission,while there was no significant difference at 2 h after admission.But as for Cys-C,there were significant differences between the two groups at 2 h,24 h and48 h after admission(P < 0.05).There was no correlation between cys-c1-3 and Scr1, but there was positive correlation between Cys-C and Scr2-3(P < 0.05).Serum Scr and Cys-C and were both negatively correlated with GFR(P < 0.05).The correlation coefficient between Cys-C and GFR was higher than that between Scr and GFR.The area under the ROC curve of Scr1 in the observation group was 0.5,and the area under the ROC curve of Scr and Cys-C at other time points was above0.8.The AUC of Cys-C for 2 h after admission in the observation group was about 0.815 and the critical value of Cys-C was1.15 mg/L.The AUC value of Scr was about 0.546 and the critical value was 110μmol/L. Conclusion Blood Cys-C level is significantly increased in patients with acute kidney injury associated with sepsis,which can reflect kidney injury earlier than Scr and is of great significance for the early identification of acute kidney injury.更多还原