慢性肾衰竭患者血清肌红蛋白、肌钙蛋白I校正公式的建立

Establishment of the correction formula of serum myoglobin/ troponin I for CRF patients

目的通过检测各期慢性肾衰竭患者血清肌红/肌钙蛋白I水平,推导出慢性肾衰竭患者血清肌红/肌钙蛋白I水平的校正公式,为慢性肾衰竭人群心肌梗死的诊断提供有益的参考和帮助。方法选取2009年1月至2011年1月期间我院肾病内科慢性肾衰竭患者211例,检测血清肌红蛋白、血清肌钙蛋白I、血肌酐、尿素氮、肾小球滤过率、内生肌酐清除率及血清胱抑素C等指标,探讨血清肌红/肌钙蛋白I与血肌酐、尿素氮、血红蛋白和血清胱抑素C等指标的相关性,找出与其关系密切的指标,进而推导出其与血清肌红/肌钙蛋白I关系的校正公式。结果慢性肾衰竭患者血清肌红/肌钙蛋白I随血肌酐水平的升高而升高,各组与肾功能正常组相比,差异均有统计学意义。经直线相关分析,血肌酐、尿素氮、血清胱抑素C与肌红蛋白及肌钙蛋白I关系密切(R值分别为:0.757、0.663、0.672/0.350、0.314、0.306,P值均<0.01)。血清肌红蛋白与肌钙蛋白I呈正相关(R值为0.423,P<0.01)。经多重线性回归分析,肌红蛋白的校正公式为Y=27.35+0.152 X1+12.521 X2+0.556 X3(X1代表血肌酐、X2代表血清胱抑素C、X3代表尿素氮),肌钙蛋白I的校正公式为:Y=0.012+0.000024X1+0.002X2(X1代表血肌酐、X2代表血清胱抑素C)。结论基于肾功能的肌红/肌钙蛋白I校正公式可为慢性肾衰竭人群急性心肌梗死的诊断提供有益的参考和帮助。

Objective The purpose of this study is detect the level of serum Mb/cTn I in patients with CRF,and to establish a correct formula of serum Mb/cTn I in CRF patients. Methods 211 patients from Affiliated Hospital of Guangdong Medical College,between January 2009 and January 2011 ,were enrolled in this study. Detect indicators in- cluding Scr,BUN, cTn I, Mb and Cys-C. Explore the correlation among Mb/cTn I and BUN, Scr,Ccr, HGB and Cys-C, then find its closely related indicators,to establish the correct formula of serum Mb/cTn I for CRF patients. Results The Mb/cTn I were increased in parallel with the increasing of Scr,and there were statistically significant between nor- mal renal function group and other groups. After a linear correlation analysis, the close relationship among Mb/cTn I and BUN,Scr,Ccr,GFR and Cys-C were Scr,BUN and Cys-C （r value：0. 757,0. 663,0. 672/0. 350,0. 314,0. 306,P〈0.01）. There are positive correlation between serum Mb and cTn I （R value：0. 423, P〈0.01）. The correct formula of Mb is Y27. 354-0. 152X1＋12. 521X2 4-0. 556X3 （X1 ：Scr,X2 ：Cys-C,Xs ：BUN）,and the correct formula of cTn I is Y=0. 0124＋0.000024X1 4-0. 002X2 （X1 ：Scr, X2 ：Cys-C）. Conclusion By establishing the correct formula for Mb/cTn I in CRF patients,could provide useful help for the diagnosis of acute myocardial infarction in patients with CRF.