中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2010年
1期
35-38
,共4页
何楠%周巧玲%洪学敏%敖翔%彭卫生%唐荣
何楠%週巧玲%洪學敏%敖翔%彭衛生%唐榮
하남%주교령%홍학민%오상%팽위생%당영
半胱氨酸蛋白酶抑制剂/代谢%肾疾病/代谢%肾功能衰竭,慢性/代谢
半胱氨痠蛋白酶抑製劑/代謝%腎疾病/代謝%腎功能衰竭,慢性/代謝
반광안산단백매억제제/대사%신질병/대사%신공능쇠갈,만성/대사
Cysteine proteinase inhibitors/ME%Kidney disease/ME%Kidney failure,chronic/ME
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ICU AKI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);tg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.
目的 觀察血胱抑素C(cysC)在不同程度急性腎損傷(AKI)及終末期腎病(ESRD)患者血清中的濃度變化,探討其對AKI的早期診斷價值及其與腎功能損傷程度的相關性.方法 搜集ICU AKI患者,"5.12"汶川地震傷員,ESRD患者及健康對照者的血清、尿液及臨床錶現等資料;按照RIFLE標準,分為輕度AKI組20例、中重度AKI組30例,另外,地震外傷組48例、ESRD組32例和健康對照組20例;採用微粒子增彊免疫比濁法檢測血清cysC,比色法檢測尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG酶),酶法檢測血肌酐(Scr);對血cysC與Scr的相關性進行統計學分析,併繪製受試者工作特徵麯線(ROC麯線),評價血cysC在AKI早期診斷中的敏感性和特異性及其與腎功能損傷程度的相關性.結果 與健康對照組比較,輕度AKI組、中重度AKI組和ESRD組血cysC均有明顯升高(P<0.05或P<0.01),其中ESRD組升高更明顯(P<0.01);血cysC與Scr呈正相關關繫(P<0.01);tg震外傷組血清cysC較健康對照組升高(P<0.05),且血cysC在AKI診斷中的ROC麯線下麵積為0.931(P<0.01).結論 AKI髮生時檢測血cysC有助于AKI的早期臨床診斷;血cysC與腎功能損傷程度呈正相關關繫,能準確反應腎功能變化.
목적 관찰혈광억소C(cysC)재불동정도급성신손상(AKI)급종말기신병(ESRD)환자혈청중적농도변화,탐토기대AKI적조기진단개치급기여신공능손상정도적상관성.방법 수집ICU AKI환자,"5.12"문천지진상원,ESRD환자급건강대조자적혈청、뇨액급림상표현등자료;안조RIFLE표준,분위경도AKI조20례、중중도AKI조30례,령외,지진외상조48례、ESRD조32례화건강대조조20례;채용미입자증강면역비탁법검측혈청cysC,비색법검측뇨N-을선-β-D-안기포도당감매(NAG매),매법검측혈기항(Scr);대혈cysC여Scr적상관성진행통계학분석,병회제수시자공작특정곡선(ROC곡선),평개혈cysC재AKI조기진단중적민감성화특이성급기여신공능손상정도적상관성.결과 여건강대조조비교,경도AKI조、중중도AKI조화ESRD조혈cysC균유명현승고(P<0.05혹P<0.01),기중ESRD조승고경명현(P<0.01);혈cysC여Scr정정상관관계(P<0.01);tg진외상조혈청cysC교건강대조조승고(P<0.05),차혈cysC재AKI진단중적ROC곡선하면적위0.931(P<0.01).결론 AKI발생시검측혈cysC유조우AKI적조기림상진단;혈cysC여신공능손상정도정정상관관계,능준학반응신공능변화.
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 wenchuan 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-acetyl-beta-D-glucosaminidase (NAGase). The enzymic method was used to detect serum creatinine. The correlation 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 and P <0. 01). The serum cystatin C was positively correlated with serum creati-nine( 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), an 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.
