目的探讨尿中白细胞介素-18(IL-18)和尿中胱抑素C(Cys C)对危重患者急性肾损伤(AKI)临床上早期诊断的价值。方法选取中山大学附属第一医院重症医学科2012年1月至2013年12月收治的危重患者为研究对象,每天收集尿标本,持续7d,应用酶联免疫吸附(ELISA)法检测尿液标本中的IL-18和颗粒增强免疫比浊法测定尿液标本中的Cys C。根据测量结果分为3组:A组(IL-18〉95pg/mL)、B组(Cys C〉1.3g/mL),C组(IL-18〉95pg/mL和Cys C〉1.3g/mL)。另选同期健康体检者作为D组(IL-18≤95pg/mL和Cys C≤1.3g/mL)。结果按α′=0.006 8检验标准,A、B、C 3组与D组AKI患病率不同,A、B、C 3组的AKI患病率远远高于D组,但A、B、C 3组之间AKI患病率几乎没有差别,差异无统计学意义。进一步两两比较采用χ2分割法,α′=0.006 8。结论 IL-18和Cys C在危重患者急性肾损伤的临床研究有早期诊断价值。
Objective To explore the value of urinary interleukin-18 (IL-18) and urine cystatin C (Cys C) in early clinical diagnosis of acute kidney injury (AKI) in critically ill patients. Methods The critically ill patients in ICU from January 2012 to December 2013 were selected as the research subjects. The daily urine samples were col- lected for consecutive 7 d. IL-18 was detected by enzyme-linked immunosorbent assay(ELISA) and Cys C was detec- ted by the particle-enhanced turbidimetric immunoassay. The measurement results were divided into three groups.. A (IL-18〉95 pg/mL),B (Cys C〉1.3 g/mL),C (IL-18〉95 pg/mL and Cys C〉1. 3 g/mL) and D as the normal group (IL-18≤95 pg/mL and Cys C≤1.3 g/mL). Results According to α'=0. 006 8 test standard,the morbidity rate of AKI had difference between the group A,B and C with the group D, the morbidity rate of AKI in the group A,B and C was much higher than that in the group D,but which had no statistically significant difference among the group A, B and C. The further pairwise comparisons adopted x^2 segmentation method, α' = 0. 006 8. Conclusion IL-18 and Cys C has a early diagnostic value for AKI in critically ill patients.