中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES
2012年
11期
839-841
,共3页
阚宝甜%刘会敏%菅向东%张伟%周倩%王洁茹
闞寶甜%劉會敏%菅嚮東%張偉%週倩%王潔茹
감보첨%류회민%관향동%장위%주천%왕길여
百草枯%肌酐%尿素氮,胱抑素C
百草枯%肌酐%尿素氮,胱抑素C
백초고%기항%뇨소담,광억소C
Paraquat%Poisoning%Kidney injury%Blood urea nitrogen%Serum creatinine%Cystatin C
目的 探讨血清尿素氮(BUN)、肌酐(Cr)、胱抑素(Cys C)及尿蛋白的动态变化在急性百草枯中毒患者肾功能损害的临床意义.方法 研究分析35例百草枯中毒患者的临床资料,以8周后存活为标准,于患者中毒的第1、3、7、14、21天及8周后分别采取空腹静脉血5ml,全自动生化仪测定血清BUN、Cr、Cys C,并留取中段晨尿测尿蛋白的水平；同时随机选取30例健康体检者作正常对照组,并排除肾脏疾病及其他泌尿系统疾病史,于查体当天采取静脉血5 ml并留取尿液检测上述指标.结果 观察期前21d中毒存活组血清BUN、Cr、Cys C的水平[(9.08±3.37) mmol/L、(169.3±21.3) μmol/L和(2.01±0.83) mg/L]较对照组[(4.57±1.45)mmol/L、(68.8±15.0) μmol/L和(0.81±0.26)mg/L]均明显升高,差异有统计学意义(P＜0.05).百草枯中毒第14天,各指标都有一定程度的回落,且血清Cys C下降的幅度低于血清BUN、Cr.第21天,35例存活患者中有29例上述肾功能指标恢复至正常参考值范围,8周后有31例恢复至正常范围,尿蛋白的阳性率在肾损伤早期相对较高(76.9％).结论 血清Cys C是反映百草枯急性中毒肾损伤的一项灵敏指标,其灵敏度优于BUN、Cr和尿蛋白,百草枯中毒所致的肾损伤具有可逆性.
目的 探討血清尿素氮(BUN)、肌酐(Cr)、胱抑素(Cys C)及尿蛋白的動態變化在急性百草枯中毒患者腎功能損害的臨床意義.方法 研究分析35例百草枯中毒患者的臨床資料,以8週後存活為標準,于患者中毒的第1、3、7、14、21天及8週後分彆採取空腹靜脈血5ml,全自動生化儀測定血清BUN、Cr、Cys C,併留取中段晨尿測尿蛋白的水平；同時隨機選取30例健康體檢者作正常對照組,併排除腎髒疾病及其他泌尿繫統疾病史,于查體噹天採取靜脈血5 ml併留取尿液檢測上述指標.結果 觀察期前21d中毒存活組血清BUN、Cr、Cys C的水平[(9.08±3.37) mmol/L、(169.3±21.3) μmol/L和(2.01±0.83) mg/L]較對照組[(4.57±1.45)mmol/L、(68.8±15.0) μmol/L和(0.81±0.26)mg/L]均明顯升高,差異有統計學意義(P＜0.05).百草枯中毒第14天,各指標都有一定程度的迴落,且血清Cys C下降的幅度低于血清BUN、Cr.第21天,35例存活患者中有29例上述腎功能指標恢複至正常參攷值範圍,8週後有31例恢複至正常範圍,尿蛋白的暘性率在腎損傷早期相對較高(76.9％).結論 血清Cys C是反映百草枯急性中毒腎損傷的一項靈敏指標,其靈敏度優于BUN、Cr和尿蛋白,百草枯中毒所緻的腎損傷具有可逆性.
목적 탐토혈청뇨소담(BUN)、기항(Cr)、광억소(Cys C)급뇨단백적동태변화재급성백초고중독환자신공능손해적림상의의.방법 연구분석35례백초고중독환자적림상자료,이8주후존활위표준,우환자중독적제1、3、7、14、21천급8주후분별채취공복정맥혈5ml,전자동생화의측정혈청BUN、Cr、Cys C,병류취중단신뇨측뇨단백적수평；동시수궤선취30례건강체검자작정상대조조,병배제신장질병급기타비뇨계통질병사,우사체당천채취정맥혈5 ml병류취뇨액검측상술지표.결과 관찰기전21d중독존활조혈청BUN、Cr、Cys C적수평[(9.08±3.37) mmol/L、(169.3±21.3) μmol/L화(2.01±0.83) mg/L]교대조조[(4.57±1.45)mmol/L、(68.8±15.0) μmol/L화(0.81±0.26)mg/L]균명현승고,차이유통계학의의(P＜0.05).백초고중독제14천,각지표도유일정정도적회락,차혈청Cys C하강적폭도저우혈청BUN、Cr.제21천,35례존활환자중유29례상술신공능지표회복지정상삼고치범위,8주후유31례회복지정상범위,뇨단백적양성솔재신손상조기상대교고(76.9％).결론 혈청Cys C시반영백초고급성중독신손상적일항령민지표,기령민도우우BUN、Cr화뇨단백,백초고중독소치적신손상구유가역성.
Objective To investigate the clinical significance of dynamic changes of blood urea nitrogen (BUN),serum creatinine (Cr),serum cystatin (Cys C) and urinary protein on renal injurys with paraquat poisoning.Methods According to the clinical manifestion and curative effect,the clinical information was analyzed retrospectively in 35 cases of acute paraquat poisoning,survival after eight weeks as the standard.Poisoning patients were taken a fasting blood 5 ml and the middle of urina on the 1st day,3rd day,7th day,14th day,21st day and 8 weeks after the poisoning.Then the levels of serum BUN,Cr,Cys C and urinary protein were detected by automatic biochemistry analyzer.30 cases healthy subjects were randomly selected as normal control group,and discharged kidney disease and other diseases of urinary system history.The same laboratory subjects have been done.Results The level of serum Bun,Cr,Cys C of survival group increased significantly compared with control group within 21 days (P＜0.05).The level of serum BUN,Cr Cys C decreasd on the 14th day.The decreased level of serum Cys C was lower than that of serum BUN and Cr.The renal function of 29 cases among 35 cases survival patients recovered on 21st day.The renal function of 31 cases among 35 cases survival patients recovered 8 weeks late.The positive rate of urinary protein of survival patients was high in the early intoxication (76.9％).Conclusion Serum Cys C is sensitive indicator to reveal the kidney injury on paraquat poisoning patients and have higher value of clinical applications in the diagnosis of the kidney injury of paraquat poisoning,which sensitivity is higher than serum BUN and Cr.The kidney injury caused by paraquat poisoning is reversible.
