血清胱抑素C对ICU老年患者急性肾损伤及死亡的预测作用

目的 评价血清胱抑素C是否可以预测ICU老年患者的急性肾损伤(AKI)及死亡风险。方法 选取入住ICU时无AKI老年患者(年龄>60岁),68例患者符合条件入选,有13人发展为AKI,入院时有24人血清胱抑素C升高,分别按照有无AKI、血清胱抑素C浓度是否高于正常值分组,对各参数进行统计学分析。结果 血清胱抑素C水平升高能预测AKI(1.82±0.58 VS 1.33±0.34,P=0.01),而且是死亡的独立预测因素(OR=5.05,95% CI:1.14~9.47,P=0.02),而AKI与死亡率无关(P=0.241)。根据ROC曲线,血清胱抑素C与AKI相比较具有更大的曲线下面积(area=0.721,P=0.02 VS area=0.455,P=0.64)。结论 高水平的血清胱抑素C能预测ICU老年患者的AKI,并且是死亡风险的独立预测因素,可以作为判断AKI及预后的血清标志物。

Predicting effect of serum Cystatin-C on elderly patients' developing AKI and mortality in ICU

Objective To determine whether serum cystatin-C can predict the probability for elderly patients to get acute kidney injury and the relevant mortality risks.Methods 68 elderly patients(aged 60 or older) without AKI at ICU admission were selected as research subjects among whom 24 had high-level serum cystatin-C and 13 later developed AKI . All the research subjects were divided into two groups according to whether they had AKI or not and whether their serum cystatin-C was higher than normal or not. All the parameters were statistically analyzed.Results High-level serum cystatin-C can predict AKI(1.82±0.58 VS 1.33±0.34;P=0.01)and that it can be used as the independent predictor of mortality (OR=5.05, 95% CI 1.14-9.47, P=0.02), while AKI is irrelevant to mortality. According to ROC curve, the comparison between serum cystatin-C and AKI is statistically significant(Area=0.721;P=0.02 VS Area=0.455;P=0.64), which means serum cystatin-C can serve as a better predictor of mortality.Conclusion High-level serum cystatin-C can predict AKI , also it is an independent predictor of the mortality risks in elderly patients in ICU and can serve as a serum marker to evaluate AKI and prognosis.