急性肾小球肾炎早期肾损伤评估中Cys C、BUN、sCr检测的意义

Significance of Cys C,BUN and sCr level detection in assessment of early renal damage of acute glomerulonephritis

目的：探讨急性肾小球肾炎早期肾损伤评估中胱抑素C（CysC）、血尿素氮（BUN）、血肌酐（sCr）检测的意义。方法：随机选取我院肾病内科2013年5月～2015年5月收治的急性肾小球肾炎患者90例，其中AKI1期32例（A组），AKI2期28例（B组），AKI3期30例（C组），另选取同期在我院行常规体检的健康志愿者35例作为对照组。对所有研究对象分别检测CysC、BUN、sCr，并进行APACHEⅡ评分，分析APACHEII评分与CysC、BUN、sCr水平的相关性，并对CysC、BUN、sCr水平检测在急性肾小球肾炎早期肾损伤评估中的意义进行分析。结果：各组CysC、BUN、sCr水平和APACHEⅡ评分差异均具有统计学意义（P均〈0．05）；3组急性肾小球肾炎患者APACHEⅡ评分和CysC、BUN、sCr水平呈正相关（P均〈0．05）；CysC、BUN、sCr在急性肾小球肾炎患者早期肾损伤诊断中，ROC曲线下面积分别为0．946、0．832、0．896。结论：CysC、BUN、sCr水平随着急性肾小球肾炎早期肾损伤程度的加重均显著升高，尤其是CysC水平灵敏度和特异度均比较高，具有较高的临床应用价值。

Objective： To study the significance of Cys C, BUN and sCr level detection in assessment of early renal dam- age of acute glomerulonephritis. Methods： 90 cases of patients with acute glomerulonephritis treated in Nephrology Department of our hospital from May 2013 to May 2015 were randomly selected, among whom 32 cases of AKI 1 stage （A group）, 28 ca- ses of AKI 2 stage （B group） and 30 cases of AKI 3 stage （C group）, and 35 cases of healthy volunteers receiving routine phys- ical examination in our hospital during the same period were selected as control group. Cys C （Cystatin C）, BUN （blood urea nitrogen） and sCr （serum creatinine） were detected, and APACHE Ⅱ scoring （acute physiology and chronic health status score） was conducted in all research subjects. The correlation of APACHE Ⅱ scores with Cys C, BUN and sCr levels was ana- lyzed respectively, and the significance of Cys C, BUN and sCr level detection in assessment of early renal damage of acute glo- merulonephritis was analyzed. Results： The differences in Cys C, BUN and sCr levels and APACHE Ⅱ scores among groups were statistically significant （P all 〈0. 000） ; there was significant positive correlation between APACHE Ⅱ scores and levelsof Cys C, BUN and sCr of three groups of patients with acute glomerulonephritis, and the differences were statistically signifi- cant （P〈0.05） ; in the diagnosis of early renal damage in patients with acute glomerulonephritis, the areas of Cys C, BUN and sCr under ROC curve were 0. 946, 0. 832 and 0. 896 respectively. Conclusion.. Cys C, BUN and sCr levels significantly increase with the increase of early renal damage of acute glomerulonephritis, both sensitivity and specificity of Cys C level are higher, and it has higher clinical application value.