血清胱抑素-C与慢性阻塞性肺疾病急性加重相关性研究

Relationship between Cystatin C and Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:探索血清胱抑素-C(Cys-C)与慢性阻塞性肺疾病急性加重(AECOPD)的相关性。方法:回顾性分析2012年5月1日-11月30日收治的笔者所在医院呼吸科所有确诊为AECOPD的住院患者,根据入选标准及排除标准,共54例纳入研究,其中男37例,女17例,平均年龄(66.98±8.07)岁,并随机选择同期处于COPD稳定期患者30例为对照组,男21例,女9例,平均年龄(64.17±10.03)岁,记录两组血清肌酐、尿素氮、Cys-C、肾小球滤过率及住院时间。结果:AECOPD组较对照组Cys-C水平明显高,分别为(1.12±0.26)mg/L、(0.95±0.23)mg/L,差异有统计学意义(P=0.003)。AECOPD组中Cys-C增高患者与Cys-C正常患者尿素氮水平、住院时间分别为(6.98±1.52)mmol/L和(5.21±1.94)mmol/L、(9.13±3.81)d和(7.23±2.41)d,差异有统计学意义(P值分别为0.002和0.033)。AECOPD组Cys-C水平与血尿素氮及住院时间呈正相关,有统计学意义(P<0.05)。结论:Cys-C可反映AECOPD患者早期肾功能损害,是影响AECOPD患者住院时间的一项重要因素。

Objective： To discover the relationship between Cys-c and AECOPD.Method： Retrospective analysis of all inpatients with AECOPD in deprtment of respiratory, writer＇s hospital during May 1 to November 30, 2012.According to the inclusion criteria and exclusion criteria, 54 patients with AECOPD confirmed by physical examination were randomly selected as AECOPD group, 37 were male and 17 were female.Their average age was （66.98 ± 8.07）years.Neanwhile, 30 patients with stable COPD during the same period were selected as control group, 21 were male and 9 were female.Their average age was （64.17± 10.03）years.Serum creatinine, urea nitrogen, Cys-C, GFR and lengths of stay were recorded for above two groups.Result： Cys-C value of AECOPD group was significandy higher than control group, with （1.12 ± 0.26）mg/L vs （0.95 ± 0.23）mg/L respectively, there was significant difference（P=0.003）.In AECOPD group, there were significant difference between Cys-C elevated subgroup and Cys-C normal subgroup for urea nitrogen level and length of stay, with （6.98 ±1.52）mmol/L vs （5.21 ±1.94）mmol/L（P=0.002） and （9.13 ± 3.81） vs （7.23 ±2.41）days（P=0.033）.Cys-C shared positive correlations with urea nitrogen and lengths of stay （P〈0.05）.Conclusion： Cys-C can reflect early renal impairment and is an important factor for affecting lengths of stay in patients with AECOPD.