血清胱抑素C与肌酐在急性肾损伤患者早期诊断及预后评价中的价值

目的：探究血清胱抑素C（CysC）与肌酐（Scr）对急性肾损伤的早期诊断价值。方法：选择我院2012年10月～2013年7月经临床确诊的急性肾损伤患者86例设为观察组，另选取同期入住ICU未惠急性肾损伤的患者45例为对照组，以免疫比浊法测定血清CysC和Scr水平，用ROC评价其诊断价值，并用Cockroft—Gault公式估算肾小球滤过率（OFR）。结果：与对照组相比，观察组血清CysC、Scr以及肾小球滤过率均有显著变化（P〈0．05），且观察组各分期的CysC和Scr水平与对照组相比亦均有显著提高（P〈0．05），不同分期CysC和Scr测定结果差异无统计学意义（P〉0．05）。观察组血清CysC和Scr呈线性正相关（r=0．881，P〈0．01），和GFR率呈负相关（r=-0．421，P〈0．05），回归方程为（CysC）^-1=0．1875＋0．0052eGFR。结论：与血清Scr相比，血清CysC能更加敏感、准确地反映肾损伤程度，对于合理制定治疗方案、评估预后能提供可靠科学的依据，具有重要的临床意义。

Value of serum Cystatin C and serum creatinine in early diagnosis and prognosis of acute kidney injury

Objective： To study the value of serum cystatin C （CysC） and serum creatinine （Scr） in the prediction and prognosis of acute kidney injury （AKI）. Methods： A total of 86 cases with AKI were se- lected as the observation group from October 2012 to July 2013, while another 45 in the ICU without AKI as the control group. The level of Cys C and Scr were detected by immunoturhidimetric method. SerumCys C and glomerular filtration rate were detected by ROC and Cockroft-Gault equation. Results： The lev- el of Cys C, Scr and eGFR in the observation group were significantly higher than that in the control group （P〈0.05）, and the level of serum Cys C and Scr in observation group was increased significantly com- pared with the control （P〈0.05）, and there were no statistical difference in the level of serum Cys C and Scr among three subgroups （P〉0. 05）0 The increased serum Cys C was positively related to serum creati- nine （r=0. 881, P〈0.01） and negatively related to the glomerular filtration rate （r=-0. 421,P〈0.05） with the regression equation of （Cys C）-1=0. 1875＋0. 0052eGFR. Conclusions. Compared with the Ser, serum Cys C is more sensitive and accurate. It is positively correlated with renal function, and can reflect changes in renal function accurately.