血清光抑素C和尿N-乙酰-β-D-氨基葡萄糖苷酶对脓毒症早期肾功能损伤的预测价值

目的：探讨血清光抑素C和尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）对脓毒症患者早期肾功能损伤的预测价值。方法：回顾分析2009年3月—2010年11月我院重症监护病房（ICU）收治住院的脓毒症患者63例,入住ICU后立即测定血清光抑素C、肌酐、尿素氮、血尿β2微球蛋白（β2MG）及尿NAG,并于入院后第3天复查。同时入院后第3天复查肾功能,根据患者肾功能指标分为肾功能不全组34例,肾功能正常组29例。结果：入院时2组患者血清光抑素C和尿NAG比较有显著差异,血清肌酐、尿素氮和血尿β2MG比较无显著差异;入院第3天患者血清光抑素C、肌酐、尿素氮、血尿β2MG及尿NAG、比较均有显著差异,血清光抑素C、尿NAG水平升高与肌酐升高水平呈正相关。结论：血清光抑素C和尿NAG水平对于预测脓毒症患者早期肾功能受损具有重要的临床价值。

Investigation on Prediction Value of Cystatin C and N-acety-β-D-glucosaminidase on Early Phase of Renal Impairment in Sepsis Patients

Objective：To investigate the prediction value of cystatin C and N-acety-β-d-glucosaminidase（NAG） on early phase of renal impairment in sepsis patients.Methods： A retrospective analysis of 63 cases of sepsis patients were admitted in ICU of our hospital from March 2009 to November 2010.The level of serum cystatin C,NAG,creatinine,urea nitrogen,and β2-microglobulin of blood and urine were measured immediately after admission an on the third day in all patients.All figures were measured again on the third day after admission.Results： Thirt-four of all 60 patients were diagnosed with early phase of renal impairment（group of renal impairment） and 29 ones were with normal renal function（group of normal renal function）.There was a significant difference between the two groups in the level of serum cystatin C and NAG（P0.05）.There was no significant difference in the level of creatinine,urea nitrogen and β2-microglobulin of blood and urine between the two groups（P0.05）.There was a significant difference between the two groups in the level of all figures on the third day after admission（P0.05）.The level of serum cystatin C and NAG was significantly correlated with creatinine in those patients.Conclusions： The level of serum cystatin C and NAG in early phase has an important prediction value on early phase of renal impairment in sepsis patients.