血清胱抑素C测定在监测万古霉素致早期肾损害中的意义

Significance of serum cystatin C in vancomycin-induced early kidney injury

目的探讨血清胱抑素C(CysC)测定在监测万古霉素致早期肾损害中的意义。方法既往无肾脏疾病、在广州医学院第一附属医院接受万古霉素治疗的患者60例,检测患者万古霉素血药浓度的同时检测CysC、血尿素氮(BUN)、血肌酐(Cre),分析其与血药浓度的相关性。结果 60例患者中CysC、BUN、Cre升高率分别为63.3%、47.5%和0;CysC与BUN或Cre对万古霉素所致肾损伤检测的阳性率差异有统计学意义(P<0.05);万古霉素浓度与CysC、BUN、Cre分别呈中度、低度相关以及不相关;万古霉素血药浓度<15mg/L与>15mg/L的患者,其CysC水平差异有统计学意义。结论 CysC是一项优于BUN和Cre的用于监测万古霉素所致早期肾损害的良好指标。

Objective To evaluate the significance of serum cystatin C in vancomycin-induced early kidney injury.Methods Sixty patients receiving vancomycin therapy in The First Affiliated Hospital of Guangzhou Medical College were enrolled in this study.None of these patients had a clinical history of kidney diseases.The levels of serum vancomycin concentration in these patients were monitored and analyzed for the correlation with the levels of serum cystatin C（CysC）,blood urea nitrogen（BUN） and creatinine（Cre）.Results Elevation of serum Cys C（63.3%） and BUN（47.5%） was noted in patients with vancomycin-induced early kidney injury.A medium to low degree of correlation between serum vancomycin concentrations and CysC/BUN was observed.There was no correlation between the level of vancomycin and Cre.Furthermore,a significant difference in the CysC level was seen in patients with high（15 mg/L） or low（15 mg/L） concentration of serum vancomycin.Conclusion CysC may be a good serum marker for the diagnosis of vancomycin-induced early kidney injury.