血清胱抑素C早期升高对复苏后患者预后的影响

Effect of early increase of serum cystatin C on prognosis of patients after resuscitation

目的:检测复苏后患者早期血清胱抑素C(Cys-C)的变化,研究Cys-C早期升高对该类患者预后的影响。方法:前瞻性研究2014-01-01-2016-06-01南京医科大学第一附属医院和南京军区南京总医院收治的心搏骤停(CA)后达到自主循环恢复(ROSC)患者,按患者入院24h内Cys-C升高是否≥3%,分为Cys-C升高组和Cys-C未升高组。比较2组患者急性肾损伤(AKI)发生率、ICU住院时间、肾脏替代治疗率和60d内病死率。结果:共49例复苏后患者入组,Cys-C升高组和Cys-C未升高组分别为32例和17例。2组患者ICU住院时间、肾替代治疗比较差异无统计学意义,而Cys-C升高组患者AKI发生率、60d病死率明显高于Cys-C未升高组(P<0.05)。结论:对于复苏后达到ROSC的患者,早期血清Cys-C升高可能提示更高的AKI发生率,以及不良预后。

Objective.. The serum levels of Cys-C in the early stage of resuscitation were measured, and the effects of early elevated Cys-C on the prognosis of these patients were studied. Method：This was a prospective ob- servational study of patients with autonomic circulatory recovery （ROSC） who underwent cardiac arrest （CA） in the First Affiliated Hospital of Nanjing Medical University and Nanjing General Hospital of Nanjing Military Com- mand between January 1,2014 and June 1,2016. According to weather Cys-C ≥3 % within 24 hours after admis- sion,patients were divided into Cys-C elevated group and Cys-C un-elevated group. The incidence of acute renal in- jury （AKI）, ICU stay, renal replacement therapy and 60-day mortality were compared between the two groups. Re- suit：Among 49 included patients, 32 patients with elevated Cys-C and 17 patients with un-elevated Cys-C. There were no significant differences in ICU stay and renal replacement therapy between the two groups. The incidence of AKI and 60-day mortality in Cys-C elevated group were significantly higher than those in Cys-C un-elevated group （P〈0.05）. Conclusion.. In patients with ROSC after resuscitation, early elevated serum Cys C levels may indicate a higher incidence of AKI and poor prognosis.