血清胱抑素C在重度烧伤患者急性肾损伤诊断中的价值

Serum cystatin C as an early biomarker for acute renal injury in severe burn patients

目的探讨血清胱抑素C(CysC)对严重烧伤患者早期肾功能损害的预测价值。方法入选重度烧伤患者56例,测定入院第2天及第7天血清CysC、肌酐(Scr)等指标。采用24 h尿肌酐清除率(24h-CrCl)作为参考肾小球滤过率(rGFR),分别采用Cockcroft-Gault公式、中国成人简化MDRD公式、基于CysC的GFR估算公式和CysC联合Scr公式计算估测的GFR(GFR CG、GFR C-MDRD、GFR CysC和GFR C-CysC+Scr),分析各公式估测的GFR与rGFR的一致性。结果 GFR CysC与rGFR的一致性优于GFR CG和GFR C-MDRD,但差于GFR C-CysC+Scr。结论在重度烧伤患者中,CysC是急性肾功能受损的敏感指标,利用血清CysC联合Scr估算GFR的准确性高于单纯基于Scr估算值。

Objective To evaluated the diagnostic significance of serum cystatin C （CysC） in accurate in acute renal function impairment in sever burn patients. Methods A total of 56 adult patients with major burn injury were enrolled. Renal function was assessed using SCr - based formulae （ GFRcc and GFRc_MDRD ） and CysC - based formulae （GFRCysC and GFRC-CysC＋Ser ） on the second day and the seventh days post -burn. The 24 -h urinary creatinine clearance （24- hCrCl） was used as reference GFR （rGFR）. The consistence between rGFR and estimated GFR was tested with Bland -Altman analysis. Results CysC -based formulae for estimated GFR was more accurate and sensitive for detection of impaired renal function than SCr - based formulae. The combination of CysC and Scr for estimated GFR was most accurate. Conclusion CysC is a more accurate and sensitive marker in identification of acute impaired renal function in major burn patients than Scr.