| 范 丽,岳丽丽,朱功民,刘之荷,张 辉.血清胱抑素C、同型半胱氨酸及β2-微球蛋白在急性肾损伤患者中的动态变化及诊断价值分析[J].,2019,19(24):4670-4673 |
| 血清胱抑素C、同型半胱氨酸及β2-微球蛋白在急性肾损伤患者中的动态变化及诊断价值分析 |
| Dynamic Changes and Diagnostic Value of Serum Cystatin C, Homocysteine and β2- microglobulin in Patients with Acute Kidney Injury |
| 投稿时间：2019-06-18 修订日期：2019-07-15 |
| DOI：10.13241/j.cnki.pmb.2019.24.015 |
| 中文关键词: 急性肾损伤 胱抑素C 同型半胱氨酸 ?茁2-微球蛋白 APACHEⅡ评分 诊断 预后 |
| 英文关键词: Acute kidney injury Cystatin C Homocysteine β2-microglobulin APACHE Ⅱ score Diagnostic Prognosis |
| 基金项目:江苏省科技厅社会发展项目（BE2016719）；南京市医学科技发展项目（YKK13111） |
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| 中文摘要: |
| 摘要 目的：研究血清胱抑素C（CysC）、同型半胱氨酸（Hcy）及β2-微球蛋白（β2-MG）在急性肾损伤（AKI）患者中的动态变化及诊断价值。方法：选取2016年3月～2018年12月于南京市第一医院接受诊治的123例AKI患者作为研究对象。将其按照AKI分期分为AKI 1期组60例、AKI 2期组33例、AKI 3期组30例，另选取同期于南京市第一医院体检的健康人员40例作为对照组。分别比较四组人员的血清CysC、Hcy、β2-MG水平以及APACHEⅡ评分，并作相关性分析。比较AKI患者血清CysC、Hcy、β2-MG水平单独检测以及联合检测的检出率。此外，将AKI患者按照预后的差异分为存活组93例以及死亡组30例。比较两组患者的血清CysC、Hcy、β2-MG水平以及APACHEⅡ评分。结果：对照组、AKI 1期组、AKI 2期组、AKI 3期组血清CysC、Hcy、β2-MG水平呈逐渐升高趋势，随着AKI分期的增加，APACHEⅡ评分亦升高（均P＜0.05）。经Pearson相关性分析可得：AKI患者APACHEⅡ评分与血清CysC、Hcy、β2-MG水平均呈正相关关系（均P＜0.05）。AKI患者血清CysC、Hcy、β2-MG联合检测的检出率明显高于单独检测。AKI患者存活组的血清CysC、Hcy、β2-MG水平以及APACHEⅡ评分均低于死亡组（均P＜0.05）。结论：血清CysC、Hcy、β2-MG水平在AKI患者中明显高表达，且随着患者病情的不断加重，上述三项血清学指标水平以及APACHEⅡ评分随之增加。临床工作中通过联合检测血清CysC、Hcy、β2-MG水平，将有助于AKI患者的诊断以及预后评估。 |
| 英文摘要: |
| ABSTRACT Objective: To study the dynamic changes and diagnostic value of serum cystatin C (CysC), homocysteine (Hcy) and β2-microglobulin (β2-MG) in patients with acute kidney injury (AKI). Methods: 123 patients with AKI who received treatment in Nanjing First Hospital from March 2016 to December 2018 were selected as research objects. According to AKI stages, the patients were divided into the AKI 1 group of 60 cases, the AKI 2 group of 33 cases, and the AKI 3 group of 30 cases. Another 40 healthy patients who received physical examination in Nanjing First Hospital during the same period were selected as the control group. Serum CysC, Hcy, β2-MG levels and APACHE II score were compared among the four groups, and the correlation was analyzed. The detection rates of serum CysC, Hcy and β2-MG levels in patients with AKI by independent and combined detection. In addition, patients with AKI were divided into 93 patients in the survival group and 30 patients in the death group according to the difference in prognosis. The serum CysC, Hcy, β2-MG levels and APACHE Ⅱ scores were compared between the two groups. Results: The control group, AKI 1 group, AKI 2 group, AKI 3 group of serum CysC, Hcy, β2 - MG levels all showed a trend of increasing gradually, with the increase of AKI stage, APACHE II score also increased (all P<0.05). The Pearson correlation analysis available: patients with AKI of APACHE Ⅱ score and serum CysC, Hcy, β2-MG levels were positively correlated relationship (all P<0.05). The detection rate of combined detection of serum CysC, Hcy and β2-MG in AKI patients was significantly higher than that of single detection. patients with AKI survival groups of serum CysC, Hcy, β2-MG levels and APACHE Ⅱ scores were lower than those of the death group (all P<0.05). Conclusion: Serum CysC, Hcy, β2 - MG levels are significantly higher expression in patients with AKI, and with the aggravation of the patient's condition, the above three serological indicators and APACHE II score increased accordingly. Clinical work may be combined with the detection of the above indicators, so as to achieve the purpose of AKI diagnosis and prognosis assessment. |
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