胱抑素C检测在造影剂肾病诊断的效果研究

Effect of Cystatin C Detection to Diagnose Contrast-Induced Nephropathy

目的研究胱抑素C检测在诊断造影剂肾病(CIN)中的应用价值。方法选取2012年10月至2014年10月于我院行碘海醇造影的140例患者作为研究对象,分别于造影前、造影12 h、造影24 h、造影48 h后采集患者静脉血液样本,测定血清胱抑素C(Cys C)、血肌酐(Scr)、尿素氮(BUN)以及尿酸(UA)水平。结果造影前,患者血清Cys C水平为(0.98±0.08)mg/L,造影12 h后上升至(1.04±0.20)mg/L,24 h上升至(1.18±0.13)mg/L,48 h下降至(1.09±0.17)mg/L,不同时间段血清Cys C水平对比差异有统计学意义(P<0.05)。但造影前、造影后患者血清Scr、BUN、UA水平无明显变化,差异无统计学意义(P>0.05)。结论含碘造影剂是引发造影剂肾病的危险因素,血清胱抑素C检测对造影剂肾损伤有较高的敏感度,可作为诊断CIN的重要指标。

Objective To explore the value of cystatin C （CysC） detection in the diagnosis of contrast-induced nephropathy （CIN）. Methods 140 patients with iohexol for radiography in our hospital from October 2012 to October 2014 were selected as research objects. Venous blood samples of all patients were collected before radiography, 12 hours after radiography, 24 hours after radiography and 48 hours after radiography to detect the levels of serum cystatin C （CysC）, serum creatinine （Scr）, blood urea nitrogen （BUN）, and uric acid （UA）. Results Before radiography, the CysC level was （0.98 ±0.08） mg/L, increased to （1.04 ±0.20） mg/L at 12 h after radiography, and （1.18 ± 0.13） mg/L at 24 haiter radiography, while decreased to （1.09 ±0.17） mg/L at 48 hours after radiography; The differences among different time periods were statistically significant （P 〈0.05）. There were no statistically significant differences in Scr, BUN and UA levels between pre-radiography and post-radiography （P〉0.05）. Conclusions Iodine contrast medium is the risk factor to induce CIN. Serum cystatin C has high sensitivity for diagnosis of contrast medium induced renal impairment, which can be used as an important indicator to diagnosis of CIN.