Scys C和 Ucys C在危重患者急性肾损伤时的诊断价值及临床意义

Diagnostic value and clinical significance of Scys C and Ucys C in critically ill patients with acute kidney injury

目的：探讨危重患者急性肾损伤（AKI）时血清胱抑素C（Scys C）及尿胱抑素C （ Ucys C）的水平变化。方法收集2013－05～2014－05我院ICU 141例危重患者资料，选取出现AKI的患者32例作为AKI组，未出现AKI的患者109例作为非AKI组，比较两组患者SCys C及UCys C水平。采用Spearman’s相关分析Scys C、Ucys C、Scr及APACHEⅡ评分之间相关性，绘制受试者工作特征ROC曲线并计算曲线下面积，分析血尿胱抑素C（ cystation C）对危重患者AKI的诊断价值，根据AKI患者Scys C和Ucys C升高率，判断其对AKI诊断价值的差异。结果①AKI组与非AKI组患者Scys C、Ucys C、Scr和APACHEⅡ评分比较差异均有统计学意义（ P＜0．05）。②Spearman’s相关分析显示，Scys C和Ucys C无相关性（P＞0．05）。③危重患者AKI影响因素的ROC曲线分析显示，Scys C和Ucys C曲线下面积分别为0．848和0．810。④χ2检验显示，AKI组患者Scys C和Ucys C升高率比较差异无统计学意义（ P＞0．05）。结论血尿Cys C可以作为重症患者发生AKI的诊断指标。 Scys C及Ucys C作为重症患者发生AKI的诊断指标时差异无统计学意义。

Objective To investigate the level of serum cystatin C （ Scys C） and urine cystatin C （Ucys C） in critically ill patients with acute kidney injury （AKI）.Methods One hundred and Forty-one critically ill patients admitted in China Petroleum Central Hospital ICU from May 2013 to May 2014 were included.Thirty-two patients with AKI were included as AKI group, and109 non-AKI patients as a control group.Scys C and Ucys C were measured and compared between these two groups.Spearman’s correlation analysis was performed to analyze the correlation among Scys C, Ucys C, and Scr, APACHEⅡscore.ROC was drawn and the area under ROC curve was calculated.The value of cystation C （ Cys C） in diagnosing was analyzed.The diagnostic value about Scys C and Ucys C was determined by the elevated rates of Scys C and Ucys C.Results ①The differences of Scys C, Ucys C, Scr and APACHEⅡscores between AKI group and non-AKI group were statistically significant （ P〈0.05）.②Spearman’s correlation analysis showed no correlation between Scys C and Ucys C （ P 〉0.05）.③The area under the curve of Scys C and Ucys C were 0.848 and 0.810, respectively in ROC curve of critically ill patients with AKI.④Chi square test showed that increase rate of Scys C and the UcysC had no significant difference of AKI patients （P〉0.05）.Conclusion CysC can be used as a diagnostic indicator of severe patients with AKI.There is no statistical difference if Scys C and Ucys C are set up as diagnostic indicators in patients with severe AKI.