胱抑素C在儿童急性肾损伤病情评估中的作用

Function of Cystatin C in Condition Assessment of Children′s Acute Kidney Injury

目的探讨胱抑素C在儿童急性肾损伤(AKI)病情评估中的作用。方法选取2010年1月—2011年12月本科诊治的AKI患儿90例,根据AKI分期标准分为AKI1期组(30例)、AKI2期组(30例)和AKI3期组(30例),以同期体检的健康儿童为对照组(30例),检测血清肌酐(SCr)和胱抑素C水平,病情评估采用急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ),记录住院期间病死率,同时分析SCr、APACHEⅡ与胱抑素C的相关性。采用SPSS 12.0软件进行数据处理。计量资料多组间比较采用方差分析;计数资料采用χ2检验;相关性分析采用直线相关分析。结果 AKI1期组、AKI2期组、AKI3期组和对照组血清SCr和胱抑素C水平比较,差异均有统计学意义(P<0.001);AKI1期组、AKI2期组和AKI3期组APACHEⅡ比较,差异有统计学意义(P<0.001)。胱抑素C水平<1.50mg/L、1.50～2.00 mg/L、>2.00 mg/L AKI患儿血清SCr、APACHEⅡ及病死率比较,差异均有统计学意义(P<0.05)。血清SCr、APACHEⅡ与血清胱抑素C均呈正相关(r值分别为0.717和0.635,P<0.05)。结论不同胱抑素C水平AKI患儿血清SCr水平不同,血清SCr与血清胱抑素C呈正相关,APACHEⅡ与血清胱抑素C呈正相关,胱抑素C可作为儿童AKI病情评估的指标。

Objective To study the function of Cystatin C in condition assessment of children＇s acute kidney injury （AKI） . Methods Select from January 2010 to December 2011 undergraduate course of treatment to children with 90 cases of AKI, divided into AKI1 group （30 cases）, AKI2 group （30 cases） and AKI3 group （30 cases）, and 30 healthy children hav- ing physical examination in the same period were involved as control group. The levels of SCr and Cystatin C were detected. The condition assessment adopted APACHE II and the fatality rate was recorded during hospitalization. The correlation of SCr, A- PACHE II and Cystatin C was analyzed. Using SPSS 12. 0 software data processing. Measurement information between group com- pares the variance analysis; Count material using cinspection; The correlation analysis using linear correlation analysis. Results The levels of SCr and Cystatin C of AKI1 group, AKI2 group, AKI3 group and control group showed statistically significant differences respectively （P 〈 O. 001 ） . The APACHE II of AKII group, AKI2 group and AKI3 group showed statistically signifi- cant difference （P 〈0. 001 ） . The levels of SCr, APACHE 1I and fatality rate in AKI children with Cystatin C 〈 1.50 mg/L, 1.50 - 2. O0 mg/L and 〉 2. O0 mg/L all showed statistically significant differences （ P 〈 O. 05 ） . SCr and APACHE ]I were posi- tively correlated with Cystatin C （ r = 0. 717 and 0. 635, P 〈 0. 05 ） . Conclusion In different inhibition change C level AKI ser- um level of children of the SCr different, serum SCr and serum inhibition change in a positive correlation between C, APACHE II and serum inhibition change in a positive correlation between C, GSH inhibition change can be as children AKI C of the dis- ease assessment index content.