连续性血液透析滤过对血清半胱氨酸蛋白酶抑制剂C的影响

目的观察血清半胱氨酸蛋白酶抑制剂C(Cystatin C,Cyst C)在连续性血液透析滤过(血滤)治疗中的变化,以期寻找血滤过程中监测肾功能的指标。方法对急性肾损伤52例行连续性血滤治疗,记录治疗前后血清肌酐(Cr)及血清Cyst C的数值,并进行比较分析。结果 52例平均血清Cyst C治疗前为(6.87±2.11)μmol/L,治疗后24、48、72 h分别为(6.34±1.89)μmol/L、(6.08±1.40)μmol/L、(5.86±2.37)μmol/L,治疗前后比较差异均无统计学意义(t=-0.364、-0.286、-0.367,P=0.233、0.179、0.154);平均血清Cr水平治疗前为(732.00±59.64)μmol/L,治疗后24、48、72 h分别为(497.00±41.31)μmol/L、(258.00±45.69)μmol/L、(173.00±55.27)μmol/L,治疗前后比较差异均有统计学意义(t=2.143、2.576、2.973,P=0.035、0.021、0.010)。结论连续性血滤治疗对血清Cyst C清除率低,血清Cyst C可作为肾替代治疗过程中监测肾功能的指标。

Influence of Continuous Hemodiafiltration on Serum Cystatin C

Objective To observe the change of serum cystatin C in the process of continuous hemodiafiltration,and to find indicators to monitor renal function during continuous hemodiafiltration. Methods 52 patients with severe acute renal injury underwent continuous blood filtration treatment,the values of both serum cystatin C and serum creatinine before and after blood filtration were recorded,compared and analyzed. Results The average serum cystatin C of the 52 cases before treatment was(6.87±2.11)μmol/L,24,48,72 h after treatment it was(6.34±1.89)μmol/L,(6.08±1.40)μmol/L,(5.86±2.37)μmol/L,the average serum cystatin C before and after treatment showed no significant statistical difference(t=-0.364,-0.286,-0.367,P=0.233,0.179,0.154).The average serum creatinine before treatment was(732.00±59.64) μmol/L,24,48,72 h after treatment it was(497.00±41.31) μmol/L,(258.00±45.69) μmol/L,(173.00±55.27) μmol/L,the average serum creatinine before and after treatment showed no significant difference(t=2.143,2.576,2.973,P=0.035,0.021,0.010). Conclusion Continuous hemodiafiltration therapy may not significantly affect the level of serum cystatin C,and serum cystatin C can been used as renal replacement therapy process indicators to monitor renal function.