目的比较分析血清肌酐(SCr)和胱抑素C(SCys-C)在脓毒症相关急性肾损伤(AKI)患者中的诊断价值。方法收集2008年10月至2009年12月我院麻醉科ICU所有无免疫抑制的成年脓毒症患者。所有脓毒症患者入室后即记录一般临床资料。脓毒症患者入室即抽血检查尿素氮(BUN)、SCr、SCys-C、C反应蛋白(CRP)等,并记录24h尿量,根据AKI网络(AKIN)的AKI诊断标准判断患者是否存在AKI,若为AKI患者则记录其诊断成立,记录确诊当天及后第1天内的SCr、SCys-C,并根据相关公式计算肾小球滤过率(GFR),比较SCr和SCys-C在AKI中的诊断价值。结果脓毒症AKI患者的CRP水平、APACHEⅡ评分、28d死亡率、住院死亡率均明显高于未发生AKI的脓毒症患者(P<0.05),AKI、APACHEⅡ评分与死亡率之间存在明显相关性。SCys-C及由此估算的GFR在AKI确诊前即发生明显改变(P<0.05),AUC-ROC分析示SCys-C可较SCr早诊断AKI,其临界值为1.15mg/L。相关性分析示AKI患者是否需要肾替代治疗(RRT),与SCr和SCys-C等肾功能指标及APACHEⅡ评...
Objective To compare diagnostic value of serum cystatin C( SCys-C) with creatinine( SCr) in sepsis related acute kidney injury( AKI). Methods All clinical data of adult septic patients without immunoparalysis were collected. As patients admitted,blood urea nitrogen( BUN) ,SCys-C,SCr and C reactive protein( CRP) were monitored. Such renal function markers were recorded if AKI was established. Glomerular filtration rate( GFR) was estimated based on SCr and SCys-C respectively. Diagnostic values of SCys-C and ...