血清胱抑素C预测神经重症患者急性肾损伤的临床价值

池锐彬, 梁美华, 罗醒政, 等. 血清胱抑素C预测神经重症患者急性肾损伤的临床价值[J]. 临床急诊杂志, 2016, 17(11): 837-840. doi: 10.13201/j.issn.1009-5918.2016.11.006
引用本文: 池锐彬, 梁美华, 罗醒政, 等. 血清胱抑素C预测神经重症患者急性肾损伤的临床价值[J]. 临床急诊杂志, 2016, 17(11): 837-840. doi: 10.13201/j.issn.1009-5918.2016.11.006
CHI Ruibin, LIANG Meihua, LUO Xingzheng, et al. Clinical value of serum Cystatin C in predicting acute kidney injury in critically neurological patients[J]. J Clin Emerg, 2016, 17(11): 837-840. doi: 10.13201/j.issn.1009-5918.2016.11.006
Citation: CHI Ruibin, LIANG Meihua, LUO Xingzheng, et al. Clinical value of serum Cystatin C in predicting acute kidney injury in critically neurological patients[J]. J Clin Emerg, 2016, 17(11): 837-840. doi: 10.13201/j.issn.1009-5918.2016.11.006

血清胱抑素C预测神经重症患者急性肾损伤的临床价值

  • 基金项目:

    中山市科技攻关医学计划项目(No:2016B1083)

详细信息
    通讯作者: 池锐彬,E--mail:CRB77970922@163.com
  • 中图分类号: R692

Clinical value of serum Cystatin C in predicting acute kidney injury in critically neurological patients

More Information
  • 目的:探讨血清胱抑素C(sCysC)预测神经重症患者发生急性肾损伤(acute kidney injury,AKI)临床价值。方法:前瞻性入选2015-03-2015-12入住南方医科大学附属小榄医院重症医学科(ICU)的110例神经重症患者。以KDIGO标准为诊断标准,将患者分为非AKI组和AKI组,比较各组患者sCysC及血肌酐(sCr)水平。运用受试者工作特征(ROC)曲线及曲线下面积(AUC)评价sCysC对AKI的诊断和短期预后的预测价值。结果:110例患者中有39例发生AKI,AKI发生率为35.5%。AKI组患者sCysC水平明显高于非AKI组,差异有统计学意义(P<0.05)。sCysC预测AKI和重症AKI的AUC分别为0.946和0.936,预测肾脏替代治疗的AUC为0.952。本研究队列中,住院死亡率为12.7%,肾脏替代治疗率为4.5%,AKI组的住院死亡率及肾脏替代治疗率均明显高于非AKI组(均 P<0.05)。结论:sCysC是预测神经重症患者发生AKI及预后的可靠指标,并且提供判断患者短期预后的相关信息。
  • 加载中
  • [1]

    鲁力,文玉明,马渝,等.严重颅脑损伤并发急性肾损伤的时相特征及原因分析[J].中国急救医学,2010,30(12):1082-1085.

    [2]

    Baqshaw S M,Georqe C,Gibney R T,et al.A multicenter evaluation of early acute kidney injury in critically ill trauma patients[J].Ren Fail,2008,30(6):581-589.

    [3]

    Zhou Q G,Zhao C,Xie D,et al.Acute and acute-onchronic kidney injury of patients with decompensated heart failure:impact on outcomes[J].BMC Nephrol,2012,13:51.

    [4]

    Nejat M,Pickering J W,Walker R J,et al.Rapid detection of acute kidney injury by plasma cystatin C in the intensive care unit[J].Nephrol Dial Transplant,2010,25(10):3283-3289.

    [5]

    Yung Y J,Lee H R,Kwon O J.Comparison of serum cystatin C and creatinine as a marker for early detection of decreasing glomerular filtration rate in renal transplants[J].J Korean Surg Soc,2012,83(2):69-74.

    [6]

    付燕,赵斌.急性肾损伤早期诊断的生物标志物[J].中国危重病急救医学,2012,24(9):571-573.

    [7]

    Kidney Disease:Improving Global Outcomes(KDIGO)Acute Kidney Injury Work Group.KDIGO Clinical Practice Guideline for Acute Kidney Injury[J].Kidney International,2012,2(1):1-138.

    [8]

    Bagshaw S M,Bellomo R.Cystatin C in acute kidney injury[J].Curr Opin Crit Care,2010,16(6):533-539.

    [9]

    Zhang Z,Lu B,Sheng X,et al.Cystatin C in prediction of acute kidney injury:a systemic review and meta-analysis[J].Am J Kidney Dis,2011,58(3):356-365.

    [10]

    Song S,Meyer M,Türk T R,et al.Serum cystatin C in mouse models:a reliable and precise marker for renal function and superior to serum creatinine[J].Nephrol Dial Transplant,2009,24(4):1157-1161.

    [11]

    石海鹏,徐道妙,王国恩.ICU内急性肾损伤患者的预后指标分析[J].中华急诊医学杂志,2010,19(4):409-412.

    [12]

    Bell M,Granath F,Mårtensson J,et al.Cystatin C is correlated with mortality in patients with and without acute kidney injury[J].Nephrol Dial Transplant,2009,24(10):3096-3102.

    [13]

    Corral L,Javierre C F,Ventura J L,et al.Impact of non-neurological complications in severe traumatic brain injury outcome[J].Crit Care,2012,16(2):R44.

    [14]

    Ahmed M,Sriganesh K,Vinay B,et al.Acute kidney injury in survivors of surgery for severe traumatic brain injury:Incidence,risk factors,and outcome from a tertiary neuroscience center in India[J].Br J Neurosurg,2015,29(4):544-548.

    [15]

    Ray B,Rickert K L,Welch B G,et al.Development of contrast-Induced nephropathy in subarachnoid hemorrhage:a single center perspective[J].Neurocrit Care,2013,19(2):150-156.

  • 加载中
计量
  • 文章访问数:  118
  • PDF下载数:  50
  • 施引文献:  0
出版历程
收稿日期:  2016-07-15

目录