RBP和ScysC评估上尿路结石并积水和感染所致肾损伤的应用分析

Application analysis of RBP and ScysC on the assessment of kidney injury induced by upper urinary calculi with hydrops and infection

目的:评估血清胱抑素C(ScysC)和血清视黄醇结合蛋白(RBP)对上尿路结石并积水和感染所致肾功能损伤的临床应用价值。方法:收集2020年1月至2020年12月收治于泌尿外科的上尿路结石合并积水和感染的成人患者,总共147例。上尿路结石并积水和感染所致肾功能损伤是指,入院时血清肌酐(Scr)水平较正常值上线升高至少26μmol·L^(-1)。据此,将患者分成肾损伤组和非肾损伤组。比较两组患者在入院治疗时的Scr、ScysC及RBP水平的差异。结果:有66例患者(44.90%)发生肾功能损伤。Scr、ScysC水平在肾损伤组明显高于非肾损伤组,差异具有统计学意义(P<0.05);而RBP水平在两组间无统计学差异(P>0.05)。对于上尿路结石并积水和感染所引起的肾功能损伤,血清RBP的临床诊断效能较低。ScysC≥1.24 mg·L^(-1)会显著增加上尿路结石并积水和感染所致肾功能损伤的风险。结论:ScysC对早期评估上尿路结石并积水和感染所致肾功能损伤具有较高的临床应用价值,而血清RBP尚缺乏敏感性和特异性。

Objective:To evaluate the clinical value of serum cystatin C(ScysC)and serum retinol binding protein(RBP)on kidney injury induced by upper urinary calculi with hydrops and infection.Methods:A total of 147 adult patients with upper urinary calculi with hydrops and infections who were admitted to the Urology surgery from January 2020 to December 2020 were collected.The renal dysfunction induced by upper urinary calculi with hydrops and infection was defined as an increase in serum creatinine(Scr)level≥26μmol·L^(-1)from the upper normal value at the time of admission.Patients were classified into renal dysfunction group and no dysfunction group,on bases of the occurrence of renal dysfunction.The differences of Scr,ScysC and RBP levels at the time of admission between the two groups of patients were comparisons.Results:Sixty-six patients(44.90%)occurred renal dysfunction.The levels of Scr and ScysC in patients with renal dysfunction were obviously higher than patients with no dysfunction,with significant(P<0.05);while there was no statistical difference of RBP level between the two groups(P>0.05).The clinical diagnostic efficacy of RBP was low for the renal dysfunction induced by upper urinary calculi with hydrops and infection.ScysC≥1.24 mg·L^(-1) was the threshold value that would significantly increase the risk of renal dysfunction induced by upper urinary calculi with hydrops and infection.Conclusion:ScysC has a high clinical value for early assessment of renal dysfunction induced by upper urinary calculi with hydrops and infection,while serum RBP still lacks sensitivity and specificity.