血清胱抑素C、尿微量蛋白联合检测在万古霉素致早期肾损害中的应用

目的探讨血清胱抑素C、尿微量蛋白(β2-微球蛋白、α1-微球蛋白、转铁蛋白、微量白蛋白)联合检测在万古霉素致早期肾损害中的临床价值。方法 40例耐甲氧西林金黄色葡萄球菌(MRSA)肺部感染患者,应用万古霉素治疗前后联合检测血清胱抑素C、尿微量蛋白的变化。结果 40例MRSA肺部感染患者应用万古霉素治疗后,血清胱抑素C、尿微量蛋白阳性率明显高于血肌酐、尿素氮和尿常规阳性率(P均<0.05)。老年患者万古霉素治疗后血清胱抑素C、尿微量蛋白阳性率明显高于中青年患者(P均<0.05)。结论老年人应用万古霉素较为安全,血清胱抑素C、尿微量蛋白联合检测可早期发现万古霉素所致肾损害。

Application in combined measurement of serum levels of cystatin C and urinary microproteins in patients with early renal injury caused by vancomycin

Objective To investigate the clinical value of combined measurement of serum levels of cystatin C and urinary microproteins(β2-MG,α1-MG,TRF and mAlb)in patients with early renal injury caused by vancomycin.Methods Changes of serum cystatin C and urinary microproteins were combined measured in 40 patients with pulmonary infection of methicillin resistant staphylococcus aureus(MRSA)before and after treatment.Results The positive rate of serum cystatin C and urinary microproteins were significantly higher than those of serum creatinine,blood urea nitrogen and routine urine test(P<0.05).The positive rates of serum cystatin C and urinary microproteins in elderly patients were significantly higher than those of the younger patients(P all<0.05).Conclusion Application of vancomycin in elderly patients with pulmonary infection by MRSA is safe.Combined measurement of the serum levels of cystatin C and urinary microproteins can early detect the renal injury by vancomycin.