重症监护病房内急性肾损伤患者胱抑素C与肌酐估算肾小球滤过率的动态对比研究

Estimating glomerular filtration rate in acute kidney injury patients in intensive care unit by using creatinine and cystatin C： a dynamic comparison study

动态比较胱抑素C法（eGFRcys-c）与肌酐法（eGFRScr）估算急性肾损伤（AKI）肾小球滤过率（GFR）的差异,为完善GFR的评估提供依据.538对胱抑素C与肌酐值呈显著的正相关,换算比较eGFRcys-c要显著低于eGFRScr.提取AKI诊断前、诊断时、诊断后AKI最严重时的数据进行重复测量方差分析,显示eGFRcys-c随病情进展呈显著下降,而eGFRScr下降不明显.以eGFRcys-c为依据达到RIFLE标准AKI损伤期的时间要显著短于eGFRScr.在ICU内eGFRcys-c可能能更敏感且更早期反映AKI的GFR动态变化,因此值得深入研究.

To dynamically compare cystatin C estimated glomerular filtration rate （eGFRcys-c） and creatinine estimated glomerular filtration rate （eGFRScr） in acute kidney inju~ （AKI） patients in intensive care unit （ICU） to provide enlightenment for GFR estimation. Significant positive correlations existed between 538 paired value of cystatin C and creatinine, eGFRcys-c was significantly lower than eGFRScr. The values of eGFRcys-c and eGFRScr at 3 different timepoints were recorded for repeated measures analysis of variance. The results indicated that, with the progress of AKI, eGFRcys-c significantly decreased. eGFRScr had no significant decreases after a diagnosis of AKI. The time interval of eGFRcys-c up to the standard of RIFLE of AK1 was significant shorter than eGFRScr. In conclusion, eGFRcys-c may reflect the change of GFR more sensitive and earlier than eGFRScr in ICU AIK patients. More in-depth studies are warranted.