血清半胱氨酸蛋白酶抑制剂C评估有机磷中毒患者肾功能损害的临床价值

目的探讨血清半胱氨酸蛋白酶抑制剂C(Cystatin C,Cyst C)评估急性有机磷中毒(acute organophosphoruspesticide poisoning,AOPP)患者肾功能损害的临床价值。方法选取我院确诊的AOPP 102例作为AOPP组,于入院第1天、第3天分别测定血清尿素(BUN)、肌酐(Cr)及Cyst C;另选择同期健康体检者120例作为健康对照组,在门诊抽取静脉血检测上述指标。结果入院后第1天及第3天AOPP组BUN和Cr比较差异均无统计学意义(P>0.05),而血清Cyst C比较差异有统计学意义(P<0.05)。入院后第1天和第3天AOPP组血清BUN、Cr与健康对照组比较差异均无统计学意义(P>0.05),而Cyst C与健康对照组比较差异有统计学意义(P<0.05)。AOPP组入院后第1天血清Cyst C阳性率为49.0%(50/102),BUN与Cr联合检测阳性率为18.6%(19/102);第3天血清Cyst C阳性率为98.0%(100/102),BUN与Cr联合检测阳性率为19.6%(20/102)。结论血清Cyst C可早期反映AOPP患者肾功能损害情况,对AOPP肾功能不全的诊断及预后改善具有重要临床意义。

Clinical Value of Serum Cystatin C in Evaluation of Impairment of Renal Function in Patients with Acute Organophosphorus Pesticide Poisoning

Objective To evaluate the clinical value of serum cystatin C in renal function in acute organophosphorus pesticide poisoning(AOPP) patients.Methods 102 patients with AOPP in our hospital were recruited as AOPP group,blood urea nitrogen(BUN),creatinine(Cr) and serum cystatin C were determined on the 1st and 3rd day.120 healthy subjects were recruited as healthy control group,the blood test was taken in the outpatient department to detect these indicators.Results On the 1st and 3rd day after admission,the level of BUN and Cr of AOPP group was not statistically significant(P>0.05),but the levels of serum cystatin C showed significant difference(P<0.05);There was no significant difference in the level of BUN and Cr between AOPP group and healthy control group(P>0.05),but the level of serum cystatin C showed significant difference(P<0.05).On the 1st day after admission,the positive rate of serum cystatin C of AOPP group was 49.0%(50/102),and the positive rate of BUN and Cr combined test was 18.6%(19/162);On the 3st day after admission,the positive rate of serum cystatin C was 98.0%(100/102),and the positive rate of BUN and Cr combined test was 19.6%(20/102).Conclusion Serum cystatin C may register the early variation of renal function,suggesting that the detection of cystatin C is of great clinical significance in estimating the renal insufficiency and prognosis of the patients following AOPP.