血清胱抑素C评价肿瘤患者急性肾损伤预后的相关性分析

Correlation analysis of serum cystatin C in evaluating prognosis of patients with acute kidney injury

目的 分析血清胱抑素C评价肿瘤患者急性肾损伤(acute kidney injury, AKI)预后的相关性。方法 选取永城市人民医院2016年至2021年就诊的急性肾损伤肿瘤患者659例,根据随访期间肾功能的变化,将其分为肾功能恢复组(n=473)和未恢复组(n=186)。比较两组基线数据的差异。Logistic多因素回归分析确定肾功能难以恢复的风险,ROC曲线比较各生物标志物的预测效果。结果 两组患者年龄、BMI、高血压病、慢性肾病、血液恶性肿瘤,以及AKI诊断时ALB、BUN、Scr、CysC水平方面存在统计学差异(P<0.05)。Logistic回归显示:AKI发生后CysC、Scr、BUN、ALB水平与肾功能的恢复密切相关。此外,年龄、糖尿病、血液肿瘤与AKI后肾功能恢复失败相关。ROC曲线分析显示,ALB和BNP不能预测AKI预后,而Scr和CysC可以预测AKI预后,且具有相似的AUC,Scr的临界值为63.4,CysC的临界值为1.1。结论 血清CysC和Scr水平能够有效预测AKI肿瘤患者随访期间肾功能恢复情况,当Scr>63.4 mmol/L、CysC>1.1mg/L时AKI肿瘤患者肾功能难以恢复。

Objective To analyze the correlation of serum cystatin C in evaluating the prognosis of acute kidney injury in cancer patients. Methods A total of 659 patients with acute kidney injury and tumors treated from 2016 to 2021 were selected and divided into renal function recovery group(n=473) and non-recovery group(n=186) according to the changes in renal function during the follow-up period. Compared the differences in baseline data between the two groups. Logistic multivariate regression analysis determines the risk of renal function difficult to recover, and ROC curve compares the diagnostic effects of each biomarker. Results The two groups of patients had statistical differences in age, BMI, hypertension, chronic kidney disease, hematological malignancies, and levels of ALB, BUN, Scr, and CysC after AKI(P<0.05). Logistic regression showed that the levels of CysC, Scr, BUN and ALB were closely related to the recovery of renal function after the occurrence of AKI. In addition, age, diabetes, and hematological tumors were related to the failure of renal function recovery after AKI. ROC curve analysis showed that ALB and BNP cannot predict the prognosis of AKI, while Scr and CysC can predict the prognosis of AKI, and have similar AUC. The critical value of Scr was 63.4 and the critical value of CysC was 1.1. Conclusion Serum CysC and Scr levels can effectively predict the recovery of renal function in patients with AKI tumor during follow-up. When Scr>63.4 mmol/L and CysC>1.1 mg/L, it is difficult to recover the renal function of patients with AKI tumor.