血清胱抑素C检测诊断老年肾功能损伤的临床价值

目的探讨血清胱抑素(Cys)C及其与β2-微球蛋白(β2-MG)、尿素氮(BUN)、血肌酐(SCr)联合检测对肾功能损伤的临床价值。方法测定正常体检者和肾病患者血清CysC、β2-MG、BUN和SCr水平,并根据简化MDRD公式计算的肾小球滤过率(GFR)对研究对象分组,分析4项指标间的差异及联合测定对肾损伤的临床价值。结果与正常组相比,CysC与β2-MG水平在肾功能轻度损伤时开始增高,差异有统计学意义(P<0.01),且伴随肾功能损伤程度其水平升高越多,而BUN、SCr在肾功能损伤早期无明显变化,中、重度损伤组与正常组差异有统计学意义(P<0.01);β2-MG、BUN、SCr与CysC之间有较好的相关性(均P<0.01)。结论血清CysC水平可作为早期肾损害的一个重要指标,联合测定及动态观察CysC、β2-MG、BUN、SCr水平对肾功能损伤的诊断有重要临床应用价值。     

探讨血清胱抑素C检测诊断老年人糖尿病肾病的临床意义

目的探讨CysC在临床对于老年人糖尿病肾病诊断的意义。方法临床随机选取2011年6月—2016年6月在该院就诊的84例老年糖尿病肾病患者作为观察组,64名健康体检者作为对照组。比较两组CysC、Scr、Bun和UA浓度指标。结果观察组CysC、Scr、Bun和UA浓度均高于对照组(P0.001);观察组中CysC阳性率明显高于Scr、BUN、和UA的阳性率(P0.05)。结论该研究显示,血清CysC和Scr的水平会随着病情恶化而增高,但CysC敏感性更高,比Scr更能够清晰反映老年人肾脏受损过程。     

动脉血气指标与老年百草枯中毒患者肾损伤程度的相关性

目的观察老年百草枯中毒患者不同肾损伤程度的动脉血气指标检测结果,探析动脉血气指标与患者肾损伤程度的相关性。方法纳入老年百草枯中毒患者104例,参照急性肾损伤诊断分期标准评估其肾损伤程度,根据损伤程度进行分组,检测并比较各组入院时血清肾损伤标志物[血清肌酐(Scr)、尿素氮(BUN)、血清胱抑素(Cys)C、血清视黄醇结合蛋白(RBP)]及动脉血气分析结果[酸碱度(pH)、动脉血氧分压(PaO_2)、动脉二氧化碳分压(PaCO_2)、剩余碱(BE)、碳酸氢根(HCO~-_3)],检验动脉血气各指标与患者肾损伤各血清标志物的相关性。结果肾损伤程度:Ⅰ期22例,Ⅱ期43例,Ⅲ期39例;随肾损伤程度的加重,老年百草枯中毒患者血清Scr、BUN、RBP、CysC水平呈升高趋势,患者pH值降低,PaO_2水平升高,PaCO_2水平、BE水平及HCO~-_3水平降低,组间比较差异有统计学意义(P0.05);pH值、PaCO_2水平、BE水平、HCO~-_3水平与Scr、BUN、RBP、CysC水平均呈负相关(P0.001);PaO_2水平与Scr、BUN、RBP、CysC水平呈正相关(P0.001)。结论老年百草枯中毒患者常伴不同程度的急性肾损伤,中毒后患者动脉血气分析有明显变化,且与肾损伤程度明显相关,在未来可考虑将这些动脉血气指标的异常变化用于指导评价老年百草枯中毒患者肾损伤程度。     

儿童肾功能损害不同时期血清胱抑素C的变化及意义

检测肾功能正常组、肾功能不全代偿组、肾功能不全失代偿组、肾衰竭组、终末肾组的血清胱抑素C(CysC)血清肌酐(Scr)、内生肌酐清除率(Ccr)水平,并对CysC与Scr、Ccr的关系进行直线相关分析.结果 血清CysC在肾功能损伤的不同时期水平均升高,且随着损伤程度的加重而明显升高,与Scr呈正相关(r=0.867,P<0.01),与Ccr呈负相关(r=-0.834,P<0.01).认为CysC能准确反映肾功能损害的严重程度及肾小球滤过功能,是肾功能损害早期的敏感指标,其敏感性和特异性优于Scr、Ccr,且操作简便、易行,可做为测定GFR的敏感内源性标志物.     

血清胱抑素C在MDR-TB患者化疗中的临床应用

目的探讨血清胱抑素c（CysC）在耐多药结核（MDR—TB）患者化学治疗中的临床应用。方法对MDR—TB患者按照化疗时间不同分7组检测血清CysC,来判断患者化疗过程中氨基糖甙类注射剂及高尿酸血症对患者肾功能损伤情况,同时将7个组的血清肌酐（Scr）、尿素（Urea）、尿酸（UA）的浓度作为观察指标来测定。结果七组的血清CysC、Scr、UA的差异有显著性意义（P〈0．05）,血清Urea的差异无显著性意义（P〉0．05）,但与治疗前组相比血清CysC的浓度的变化较Scr的浓度变化出现早;在MDR-TB患者化疗过程中血清SCr、Urea无一例异常,血清uA在治疗不同时期大多数患者间或或者持续升高,血清CysC有两例在治疗2个月后出现异常,经调减注射剂剂量后恢复正常。结论血清CysC是监测MDR-TB患者化疗过程中早期肾功能损伤更敏感的指标。     

慢性肾病患者肾功能指标与肾脏病理变化的关系研究

目的探讨几种常见肾功能指标对评估慢性肾病患者肾脏病理变化的价值。方法选择2003年11月至2004年11月在苏州大学附属第二医院肾内科住院的54例慢性肾病患者,用RXL生化分析仪测定血肌酐(Scr)并通过MDRD方程计算肾小球滤过率(GFR)。检测血清胱蛋白酶抑制剂(CysC)、β2微球蛋白(β2-MG),以24h尿蛋白定量及蛋白尿持续时间的乘积计算尿蛋白指数,根据肾穿刺检查病理结果衡量肾小球指数和肾间质病变程度判定疾病进展情况。结果慢性肾病患者的血清CysC、Scr、血β2-MG、蛋白尿指数、GFR与肾脏病理变化程度相关。其中GFR和血清CysC与肾脏病理进展程度高度相关。结论在慢性肾病进展评估中应该同时考虑CysC及蛋白尿指数,能更全面地反映慢性肾脏疾病的进展情况。     

糖尿病肾损伤诊断中血清胱抑素C含量测定的应用价值探析

目的研究探讨血清胱抑素C含量测底在糖尿病肾损伤诊断中的结果及其临床应用价值。方法选取该院2015年10月—2016年10月间收治的糖尿病患者241例作为研究对象,对其血清胱抑素C、尿素氮、血肌酐等的含量进行测定,并将其按照是否合并肾损伤以及肾损伤的程度分为单纯糖尿病患者(151例)、糖尿病早期肾损伤患者(53例)、糖尿病肾病患者(37例),另取50例同期在该院接受体检的健康志愿者作为对照,行相同检测,比较不同亚组糖尿病患者和健康志愿者的各项检测指标测定结果的差异;同时,计算不同指标诊断糖尿病肾损伤的阳性率。结果糖尿病患者中,处单纯糖尿病组患者外,糖尿病早期肾损伤组和糖尿病肾病组患者的CysC、BUN、Scr检测水平均显著高于健康对照组,同时,随着糖尿病肾损伤程度的加重,各项指标的检测结果不断升高,表现出糖尿病肾病组患者糖尿病早期肾损伤组患者的情况,上述患者各项指标的比较差异有统计学意义(P0.05)。对CysC、BUN、Scr 3项指标诊断糖尿病肾损伤的阳性率进行计算和比较,可见Cys C的诊断阳性率(96.67%)显著高于BUN(64.44%)和Scr(65.56%),且比较差异有统计学意义(P0.05)。结论血清胱抑素C的含量测定可以为糖尿病肾损伤的诊断提供可靠依据,并能反映肾损伤程度情况,是一个理想的敏感性指标,临床推广应用价值。     

胱抑素C水平在妊娠高血压综合征中的临床价值

目的 探讨妊娠高血压综合征（PIH）患者分娩前后血清胱抑素C（CysC）的变化及临床研究价值。方法 选择92例PIH患者为观察组,其中轻度PIH 34例,中度PIH 31例,重度PIH 27例,同期60例正常孕妇为对照组,于妊娠晚期及产后7天分别监测各组孕妇CysC和血清肌酐（SCr）、尿素氮（BUN）、尿酸（UA）水平。结果 妊娠晚期重度PIH患者血清CysC水平明显高于对照组和轻度PIH及中度PIH患者 （P<0.05）,且随PIH发生的严重程度不同差异越明显;重度PIH组SCr、UA、BUN值均高于对照组和轻度PIH组（P﹤0.05）。与妊娠晚期比较,产后7天各组CysC值均显著降低（P﹤0.01）;BUN值：产后7天对照组、轻度PIH组、中度PIH组均高于妊娠晚期（P均≤0.01）;SCr值：产后7天重度PIH组低于妊娠晚期（P<0.05）;UA值：产后7天对照组高于妊娠晚期（P<0.05）,重度PIH组低于妊娠晚期（P<0.01）。相关分析结果显示：孕妇血压与CysC及UA之间均具有密切相关性（P均<0.01）。结论 血清CysC在PIH尤其是重度PIH时有明显变化,联合其他肾功能指标可以较灵敏地反映PIH患者的妊娠期肾功能损害和产后康复状况。     

血清胱抑素C在糖尿病肾病早期诊断中的意义

目的探讨血清胱抑素(CysC)在糖尿病肾病(DN)早期诊断中的意义。方法选取该院2015年1月—2016年1月该院就诊的2型尿病患者112例为观察组患者,按尿白蛋白排泄率(UAER)分为正常蛋白尿组(UAER30 mg/24 h)37例、微量蛋白尿组(UAER 30~300 mg/24 h)38例和临床蛋白尿组(UAER300 mg/24 h)37例,另外选取同期40名健康体检者作为对照组,采用乳胶颗粒增强免疫比浊法(PENIA)测定血清胱抑素C(CysC)、血肌酐(Scr)、尿素氮(BUN)水平,并且将4组患者的上述指标对比分析。结果血清CysC在糖尿病组均有明显升高,并且血清CysC水平随着病情的加重而逐渐增高,对照组的血清Cys C水平与正常蛋白尿组、微量蛋白尿组、临床蛋白尿组的血清Cys C水平比较,差异有统计学意义(P0.05);临床蛋白尿组的BUN、Scr水平与健康对照组、正常蛋白尿组和微量蛋白尿组BUN、Scr水平比较,差异有统计学意义(P0.05);BUN、Scr在正常蛋白尿组与微量蛋白尿组间的差异无统计学意义(P0.05)。结论 Scr、BUN水平在糖尿病早期无明显变化,CysC在糖尿病肾病早期即出现明显变化,且CysC水平与病情的严重程度密切关联,其可以作为临床诊断早期糖尿病肾病的可靠指标,对诊断早期糖尿病肾病有重要的临床意义。     

血清胱抑素C检测在肾功能损害中的临床意义

目的探讨血清胱抑素C（cystatin C,Cys C）与肾功能损害程度的相关性及临床应用价值。方法将120例肾功能损伤患者分为肾功能正常组（25例）、肾功能储备下降组（25例）、肾功能不全组（25例）、肾功能衰竭组（25例）和尿毒症组（20例）,测定各组患者血清CysC和肌酐（Scr）含量。结果各组之间CysC均有显著性差异（P〈0.01）,血清CysC浓度随着肾功能的损害程度的增加而上升,两者呈正相关。肾功能正常组血清CysC值与正常对照组相比亦有显著性差异（P〈0.05）,而两组Scr水平相比无显著性差异（P〉0.05）。结论血清胱抑素C（CysC）比Scr能更准确、直观地反映出肾小球滤过率的变化,是评估肾功能损伤程度的可靠指标。     

Lower serum cystatin C level predicts poor functional outcome in patients with hypertensive intracerebral hemorrhage independent of renal function

We explored the association between the serum level of cystatin C (CysC) at admission and short-term functional outcome in patients with hypertensive intracerebral hemorrhage (HICH) without chronic kidney disease (CKD). A total of 555 patients with HICH were consecutively recruited after admission and were followed-up for 3 months after admission. The primary outcome was poor functional outcome (modified Rankin Scale [mRS] score ≥ 3). The median serum CysC level in our cohort was 1.03 mg/L (interquartile range, .89–1.20). Patients were categorized into four groups according to the serum CysC quartiles. Multivariate logistic regression analysis revealed a negative association between serum CysC and poor functional outcome at 3-month follow-up (quartile [Q]1 vs. Q4: adjusted odds ratio [OR] = .260, 95% confidence interval [CI] = .098, .691, p < .001). The negative association between serum CysC and poor functional outcome at 3 months was more pronounced in subgroups with smaller hematoma volume (≤ 30 mL), and absence of secondary intraventricular hemorrhage (IVH). Addition of serum CysC to a model containing conventional risk factors improved the model performance with net reclassification index (NRI) of .426% (p < .001) and integrated discrimination improvement (IDI) of .043% (p < .001) for poor functional outcome. Serum CysC was found to be a negative predictor of poor short-term functional outcome in HICH patients independent of renal function.     

尿微量白蛋白、血清胱抑素C和β2微球蛋白联合检测对糖尿病肾病早期诊断的价值

目的:探讨尿微量白蛋白(mALB)、血清胱抑素C(CysC)和β2-微球蛋白(β2-MG)联合检测对糖尿病肾病早期诊断的价值。方法:根据尿微量白蛋白排泄率将115例2型糖尿病患者分为糖尿病无肾病组、糖尿病早期肾病组和糖尿病临床肾病组,45例健康体检人员为对照组;检测并比较4组mALB、血清CysC和β2-MG水平并进行相关分析。结果:糖尿病无肾病组尿mALB、血清CysC和β2-MG均明显高于对照组,差异有统计学意义(P0.05);糖尿病早期肾病组尿mALB、血清CysC和β2-MG均明显高于对照组和糖尿病无肾病组,差异有统计学意义(P0.05);糖尿病临床肾病组尿mALB、血清CysC和β2-MG均明显高于对照组、糖尿病无肾病组和糖尿病早期肾病组,差异有统计学意义(P0.05);3项指标联合检测的阳性率明显高于单项检测的阳性率;CysC和β2-MG与mALB呈正相关。结论:尿mALB、血清CysC和β2-MG都可作为糖尿病早期肾损害的敏感指标,联合检测对糖尿病肾病早期诊断具有重要的临床价值。     

Increased cystatin C levels as a risk factor of cardiovascular events in patients with preserved estimated glomerular filtration rate after elective percutaneous coronary intervention with drug-eluting stents

Chronic kidney disease (CKD) is an important risk factor for coronary artery disease (CAD) and cardiovascular events. Cystatin C (CysC) has been proposed as a sensitive marker for CKD. However, the predictive value of CysC for cardiovascular events in CAD patients with preserved estimated glomerular filtration rate (eGFR) is unclear. We enrolled 277 consecutive patients undergoing elective percutaneous coronary intervention with sirolimus-eluting stents (SES). Patients with an eGFR ≤60 ml/min/1.73 m² were excluded. Serum CysC levels were measured immediately before SES implantation. Major adverse cardiac and cerebrovascular events (MACCE) were defined as cardiovascular death, acute coronary syndrome, stroke, and hospitalization because of congestive heart failure. After a median follow-up of 63 months, 29 patients had MACCE. The subjects were divided into 2 groups based on median serum CysC levels and eGFR (0.637 mg/L and 72.43 ml/min/1.73 m², respectively). Kaplan–Meier curves showed that the high CysC group had a significantly higher occurrence of MACCE than the low CysC group (p = 0.006), although a low level of eGFR was not significantly associated with an increased risk for occurrence of MACCE. Multivariate analysis revealed that serum CysC levels were an independent predictor of MACCE [hazards ratio: 1.30 per 0.1 mg/L (1.01–1.63), p = 0.038]. These data suggested that serum CysC level is an independent predictor of MACCE, even in patients with preserved eGFR after elective SES implantation.     

Cystatin C: a step forward in assessing kidney function and cardiovascular risk

The cardiorenal syndrome is a clinical manifestation of the bidirectional interaction between the heart and kidneys. Evaluating renal function is an essential part of the assessment of every cardiac patient. It has become clear that serum creatinine is not an accurate enough marker of glomerular filtration rate (GFR) and should not be used to evaluate kidney dysfunction. Creatinine-based estimates of GFR are preferred, but require renal function to be stable and are not suitable when changes in kidney function occur. Cystatin C (CysC) has been the target of much interest in the search for an alternative measure of GFR. As an endogenous biomarker, CysC possesses many of the properties required of a good marker of renal function. Compared with that of creatinine, plasma concentrations of CysC are less influenced by factors other than GFR. Consequently, CysC correlates with true GFR more accurately than creatinine. Equations for estimating GFR from CysC values have also been developed, which makes values easier to interpret and facilitates the clinical use of this new marker. The use of CysC in acute kidney injury has also shown promising results. CysC has been studied as a risk marker for prognosis in cardiovascular disease. This effect is attributed to the strong impact of renal dysfunction on progressive cardiovascular disease and impaired survival. Higher levels of CysC have consistently been predictive of incident or recurrent cardiovascular events and adverse outcomes. CysC is a predictor of the development of heart failure and increased levels of CysC have an independent association with higher mortality in both chronic and acute heart failure. In conclusion, CysC appears to be an interesting marker of renal function and is useful for risk stratification in heart failure.     

老年患者造影剂肾损害的诊断指标探讨

目的通过对比分析老年患者造影前后血清肌酐（SCr）及血清胱抑素C（CysC）等生物学指标的变化,探讨更适用于老年患者造影剂肾损害的诊断指标。方法收集2010年5月至2011年2月于北京友谊医院医保中心及心内科接受血管造影检查的年龄≥60岁患者的相关资料共41例。用酶法测定入选患者造影前及造影后2h,24h,48h,72hSCr值。留取患者造影前及造影后2h、24h、48h、72h血清及尿液样本,予酶联免疫吸附测定法检测患者血清CysC、中性粒细胞明胶酶相关性载脂蛋白（NGAL）及尿液NGAL、肾损伤分子1（KIM-1）数值,进行造影前后的对比分析。结果依照传统造影剂肾病（CIN）的诊断标准,入选患者中1例发生CIN,患病率为2．44％。依照急性肾损伤网络（AKIN）诊断标准,入选患者中3例发生急性肾损伤,患病率为7．32％。造影后CysC升高≥25％的患者有27例,所占比例为65．9％。CysC水平在造影后24h及48h较造影前水平显著升高,SCr水平在造影前后未见明显改变。造影后CysC升高≥25％患者的血清NGAL、尿NGAL及尿KIM-1造影后的上升幅度明显高于CysC升高〈25％的患者。结论以SCr为指标的传统CIN诊断标准不适合老年患者,CysC可能更加及时、准确地反映老年患者的造影剂肾损害。     

原发性高血压患者血清胱抑素C与左室构型的关系

目的 研究心功能正常范围原发性高血压患者血清胱抑素C（CysC）水平与左室构型变化的关系,探讨左室重构与CysC的相关性,并探讨其机制.方法 纳入收缩功能正常（LVEF＞50％）原发性高血压患者180例为试验组,正常体检者50名为对照组.检测血清CysC浓度并行超声心动图检查,测量左室舒张末期内径（LVDD）、室间隔厚度（ⅣS）、左室后壁厚度（LVPW）,并计算左室重量指数（LVMI）、室壁相对厚度（RWT）.按Ganau’s分类法,将试验组分为正常型、向心性重构型、向心性肥厚型、离心性肥厚型4种构型,对各组间血浆CysC水平进行两两比较.结果 试验组较对照组血清CyaC浓度明显升高（P＜0.05）.按Ganau’s分类后,以向心性肥厚组CysC水平升高最显著（P＜0.05）,向心性构型组和离心性肥厚组依次次之（P＜0.05,P＜0.05）,正常构型组CysC水平升高最低.正常构型组较对照组CysC水平升高,但差异无统计学意义（P＞0.05）.结论 原发性高血压患者血清CysC浓度与左室构型相关,CysC在原发性高血压左室构型的变化发展中起着一定作用.     

非ST段抬高型急性冠脉综合征患者血清胱抑素C水平与GRACE评分的关系

目的：探讨非ST段抬高型急性冠脉综合征（NSTE—ACS）血浆胱抑素（Cys）C水平与全球急性冠状动脉事件注册（GRACE）评分的关系。方法：入选符合标准的NSTE—ACS患者155例,分为非ST段抬高型心肌梗死（NSTEA—MI）组和不稳定型心绞痛（UAP）组,入院后进行GRACE评分,同时第2天清晨空腹采集肘静脉血检测CysC,与87例非冠心病患者进行对照比较。结果：NSTE—ACS患者CysC、GRACE评分与非冠心病组比较均出现显著性升高（P〈0．05）,而且血清CysC水平随GRACE危险程度增加而显著升高（P〈0．05）,两者呈显著正相关（r=0．55,P〈0．01）。结论：NSTE-ACS患者CysC水平与GRACE评分密切相关。     

多指标联合检测对老年急性百草枯中毒患者肾损伤的早期诊断价值

目的探讨中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、胱抑素C(CysC)、血红素氧合酶-1(HO-1)联合检测在老年急性百草枯中毒(APP)所致急性肾损伤(AKI)患者中的早期诊断价值。方法回顾性分析,将2015年5月至2019年6月入住我院急救医学部的老年APP患者102例设为观察组,健康体检者50例设为对照组。观察组患者按入院72 h是否发生AKI分为AKI组59例和非AKI组43例。所有APP患者分别于入院即刻(0 h)、12 h、24 h、48 h、72 h检测血NGAL、CysC、HO-1、血肌酐(Scr);对照组患者体检当日检测上述指标。分析血NGAL、CysC及HO-1水平和发生AKI的相关性,绘制受试者工作特征曲线(ROC)分析NGAL、CysC、HO-1及三者联合对APP患者早期肾损伤的诊断价值。结果0 h NGAL、CysC、HO-1及Scr水平AKI组、非AKI组、对照组两两比较差异均无统计学意义(均P>0.05);观察组患者入院后各指标均呈上升趋势,12 h后AKI组与非AKI组NGAL、CysC、HO-1比较差异均有统计学意义(均P<0.05);72 h后AKI组与非AKI组Scr比较差异有统计学意义(P<0.05)。相关性分析结果显示,12、24、48、72 h NGAL、CysC、HO-1水平与APP患者AKI的发生均呈正相关,48 h相关性最强(NGAL:r=0.203、0.545、0.707、0.560,均P<0.05;CysC:r=0.242、0.340、0.754、0.467,均P<0.05;HO-1:r=0.249、0.536、0.677、0.509,均P<0.05)。绘制48 h时NGAL、CysC、HO-1、Scr及NGAL+CysC+HO-1对AKI预测的ROC曲线下面积分别为0.777、0.718、0.888、0.602、0.969。结论老年患者APP后12 h血NGAL、CysC、HO-1水平即可明显升高,48 h达高峰,其诊断AKI的时间明显早于Scr,三者联合诊断价值更高。     

Clinical correlates and heritability of cystatin C (from the Framingham Offspring Study)

Cystatin C (CysC) is associated with cardiovascular disease (CVD) and chronic kidney disease (CKD). We examined the clinical correlates and heritability of CysC and determined if associations between CVD risk factors and CysC differed by CKD status. Among Framingham Heart Study offspring (examined from 1998-2001, n = 3,241, mean age 61 years, 54% women), the 95(th) percentile cut-point was developed for CysC in a healthy subset (n = 779) after excluding participants with diabetes, hypertension, low high-density lipoproteins, obesity, smoking, high triglycerides, prevalent CVD, and CKD (as defined by glomerular filtration rate <60 mL/min per 1.73 m(2)). Multivariable logistic regression was used to evaluate the association between CVD risk factors and high CysC (CysC > or =95(th) percentile cut-point). In a family-based subset (n = 1,188), we estimated CysC heritability using the variance-components method. The cut-point for high CysC was 1.07 mg/L. Age, hypertension treatment, low diastolic blood pressure, body mass index, low high-density lipoprotein cholesterol, and smoking were associated with high CysC in multivariable models. These factors and estimated glomerular filtration rate (egFR) explained 39.2% of CysC variability (R(2)). Excluding CKD did not materially change associations. Multivariable-adjusted heritability for CysC was 0.35 (p <0.001). In conclusion, high CysC is associated with CVD risk factors even in the absence of CKD. The strong associations between CysC and CVD risk factors may partially explain why CysC is a strong predictor of incident CVD.     

老年COPD合并呼衰患者血清CysC、VEGF、ACTA水平与病情严重程度的相关性

目的分析老年慢性阻塞性肺疾病(chronic obstructive pulmonary diseases, COPD)合并呼吸衰竭(respiratory failure, RF)患者血清胱氨酸蛋白酶抑制剂C(cystatin protease inhibitor C, CysC)、血管内皮生长因子(vascular endothelial growth factor, VEGF)、激活素A(activin A, ACTA)水平与病情严重程度的相关性。 方法选择四川大学华西医院住院治疗的106例老年COPD合并RF患者为RF组,按动脉血氧分压(PaO₂)将患者分为轻度组36例、中度组41例和重度组29例,另选取医院相同时间段收治的47例单纯COPD患者为非RF组,比较各组患者血清CysC、VEGF、ACTA水平及一秒钟用力呼气容积占预计值百分比(FEV₁)、一秒钟用力呼气容积占用力肺活量百分比(FEV₁/FVC)差异,并分析血清CysC、VEGF、ACTA水平与FEV1%、FEV₁/FVC相关性。 结果RF组患者血清CysC、ACTA水平高于非RF组(P<0.05),VEGF水平、FEV1%、FEV₁/FVC低于非RF组(P<0.05);老年COPD合并RF患者病情越严重,血清CysC、ACTA水平越高,VEGF水平、FEV1%、FEV₁/FVC越低,轻度组、中度组和重度组患者组间存在显著差异(P<0.05);Pearson相关检验结果显示,老年COPD合并RF患者血清CysC与FEV1%、FEV₁/FVC均呈负相关(r＝-0.530,P<0.01;r＝-0.594,P<0.01);VEGF与FEV1%、FEV₁/FVC均呈正相关(r＝0.571,P<0.01;r＝0.668,P<0.01);ACTA与FEV1%、FEV₁/FVC均呈负相关(r＝-0.604,P<0.01;r＝-0.557,P<0.01)。 结论老年COPD合并RF患者血清CysC、VEGF、ACTA水平与其病情严重程度存在密切相关性,有助于对患者及时作出病情评估。