胱抑素C与脓毒血症患者致急性肾损伤程度的相关性研究

Relationship between the Cystatin C and the Severity of the Acute Kidney Injury in Patients with Sepsis.

目的探讨脓毒血症导致急性肾损伤(acute kidney injury,AKI)患者胱抑素C(cystatin C,CysC)表达水平与肾损伤程度之间的相关性。方法观察组:133例脓毒血症患者,按AKIN标准,依据肾损伤程度,分3组(非AKI组、轻度AKI组即AKIN分期1期,中重度AKI组即AKIN分期2、3期);对照组:40例健康体检者。测定血清CysC,血肌酐(serum creatinine,SCr),计算肌酐清除率(creatinine clearance rate,CCr),讨论CysC水平与肾损伤程度关系。结果两组AKI组CysC水平较非AKI组及健康对照组均上升,具有统计学差异(P<0.05);中重度损伤组与轻度损伤组比较,中重度损伤组CysC水平上升,具有统计学差异(P<0.01)。CysC表达水平与CCr呈负相关(r=-0.846),CysC的AUC为0.780(P<0.01)。结论脓毒血症导致AKI患者CysC表达水平与肾损伤程度呈正相关,CysC表达水平可以作为判断脓毒血症患者AKI严重程度指标之一。

Objective To explore the relationship between the Cys C and the severity of the acute kidney injury in patients with sepsis.Methods In the observer group,there were 133 cases of patients with sepsis.According to the AKIN criteria,based on the degree of renal injury,they were divided into 3 sub-groups （non-AKI group,mild AKI group was AKIN stage 1,moderate to severe AKI group was AKIN stage 2,3 period）.In the control group,there were 40 healthy people.In order to detect Cystatin C （CysC） and serum creatinine（Scr）,wealculated the creatinine clearance rate（Ccr） and analyzed the relationship between damage degree of kidney and expression level of CysC.Results The CysC of patients with acute kindey injury was significantly higher than the patients without acute kindey injury and the healthy control group（P 〈 0.05）,especially in the moderate to severe group（P 〈 0.01）.CysC in each group was negatively correlated with Ccr（r =-0.846）.And the CysC had an AUC-ROC of 0.780 （P 〈 0.01）.Conclusion In sepsis patients with AKI,CysC expression level and renal damage degree were positively correlated,which can be used as one of the indicators to judge the severity of the patients with sepsis acute renal injury.