CAJ | 학술논문

目的：评估血降钙素原（PCT）、尿素氮（BUN）、肌酐（SCr）、血胱抑素C（Cys C）和尿β2-微球蛋白（β2-MG）对脓毒症相关性肾损伤（SA-AKI）的预测价值。方法回顾性分析2012年1月至2014年12月入住PICU的脓毒症患儿共90例，按照急性肾损伤的诊断标准分为脓毒症AKI组（32例）和脓毒症非AKI组（58例）。所有患儿分别于入院时和入院后48h抽取静脉血，测定PCT、BUN、SCr、血Cys C和尿β2-MG的水平。结果⑴入院时脓毒症AKI组血Cys及尿β2-MG值明显高于脓毒症非AKI组，差异有统计学意义（P＜0.01）。血PCT、BUN及SCr比较，差异无统计学意义（P>0.05）。⑵入院48h后脓毒症AKI组血PCT、BUN、SCr、血Cys C及尿β2-MG均高于脓毒症非AKI组，差异均有统计学意义（P＜0.05或P＜0.01）。结论血CysC和尿β2-MG可作为诊断急性肾损伤早期的生物学指标；血BUN和SCr则有延迟；PCT做为预测肾功能的指标有待商榷。
목적：평고혈강개소원（PCT）、뇨소담（BUN）、기항（SCr）、혈광억소C（Cys C）화뇨β2-미구단백（β2-MG）대농독증상관성신손상（SA-AKI）적예측개치。방법회고성분석2012년1월지2014년12월입주PICU적농독증환인공90례，안조급성신손상적진단표준분위농독증AKI조（32례）화농독증비AKI조（58례）。소유환인분별우입원시화입원후48h추취정맥혈，측정PCT、BUN、SCr、혈Cys C화뇨β2-MG적수평。결과⑴입원시농독증AKI조혈Cys급뇨β2-MG치명현고우농독증비AKI조，차이유통계학의의（P＜0.01）。혈PCT、BUN급SCr비교，차이무통계학의의（P>0.05）。⑵입원48h후농독증AKI조혈PCT、BUN、SCr、혈Cys C급뇨β2-MG균고우농독증비AKI조，차이균유통계학의의（P＜0.05혹P＜0.01）。결론혈CysC화뇨β2-MG가작위진단급성신손상조기적생물학지표；혈BUN화SCr칙유연지；PCT주위예측신공능적지표유대상각。
Objective To evaluate the predictive value of serum PCT、BUN、SCr、serum Cystatin C and urine β2-microglobulin to septic associated acute kidney injury of critically ill children in PICU. Method This was a retrospective study concluding 90 patients in PICU from 2012 to 2014. These patients were divided into septic AKI group and septic non-AKI group according to Acute Kidney Injury Net. The levels of serum PCT、BUN、SCr、serum Cystatin C and urineβ2-microglobulin were measured at once and 48th hour after admitted to PICU. Results The serum CysC and urine β2-MG levels in septic AKI group were higher than those in septic non-AKI group on admission. The levels of all indexes in septic AKI group were higher than those in septic non-AKI group at 48th hour. Conclusion The serum CysC and urine β2-MG can be used as early diagnostic biomarkers for SA-AKI in PICU. BUN and SCr lack sensitivity for their retaedance. It remains unsure that PCT can be as a predictive index for AKI.