血清胱抑素C和APACHEⅡ评分在危重病患者预后中的应用价值  

Study on the relationship between serum cystatin C concentration, APACHE Ⅱ scores and the prognosis of the patients in Intensive Care Unit

作　　者：石海鹏[1] 徐道妙[1] 艾宇航[1] 赵双平[1] 明广峰[1] 马新华[1] 梁艳[1] 何家芬[1] 

机构地区：[1]中南大学附属湘雅医院ICU,410008长沙

出　　处：《中国急救医学》2009年第9期781-783,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨ICU危重病患者血清胱抑素C（cystatin C）浓度改变与急性生理学和慢性健康状况评分Ⅱ（APACHEⅡ）及预后的关系。方法采用免疫比浊法检测98例入住ICU的危重病患者的血清cystatin C浓度，并对危重病患者进行APACHEⅡ评分；分析血清cystatin C浓度与APACHEⅡ评分及病死率的关系，其中98例危重病患者按预后结果分为存活组和死亡组。结果98例患者血清cystatin C浓度（1．6±1．3）mg／L，存活组血清cystatin C浓度（1．2±1．0）mg／L，死亡组血清cystatin C浓度（2．2±1．5）mg／L，两组比较差异有统计学意义（P〈0．05）；98例患者APACHEⅡ评分（15．0±4．7）分，存活组APACHE Ⅱ评分（14．2±4．8）分，死亡组APACHEⅡ评分（17．4±3．9）分，两组比较差异有统计学意义（P〈0．01）。APACHEⅡ评分与血清cystatin C浓度呈正相关（r=0．472，P〈0．01），随各组血清cystatin C浓度的增高，APACHEⅡ评分亦增高（F=3．26，P〈0．05），病死率也增高（X^2=16．3，P〈0．01）。结论危重病患者并发肾损伤和肾功能失调的发生率较高，对判断病情及预后有一定的作用。Objective To explore the relationship between acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ） scores, serum cystatin C concentration and the prognosis of patients admitted to Intensive Care Unit. Methods The serum cystatin C levels were measured in 98 cases by immunoturbidimetry, and the relationship between APACHE Ⅱ scores, cystatin C concentration and prognosis were analyzed. Results The average cystatin C concentration of 98 cases was （ 1.6± 1.3 ） mg/L The cystatin C （ 1.2 ± 1.0 ）mg/L in the survival group was significantly lower than （ 2. 2 ±1.5 ）mg/L in the dead group （P 〈 0. 05 ）. The average APACHEⅡ scores of 98 cases was （ 15. 0 ± 4. 7 ） scores. The APACHE Ⅱ score in the survival group was （14. 2 ± 4. 8 ） scores, which was significantly lower than（17.4 ± 3.9） scores in the dead group（P 〈0.01）. The higher the serum cystatin C concentrations （ F = 3. 26, P 〈 0. 05 ） were, the higher the APACHE Ⅱ scores and the mortality （X^2 = 16. 3, P 〈 0. 01 ） were. Conclusion Serum cystatin C concentration of patients in dead group were obviously higher than those in the survival group, which plays an important role in judging the conditions and prognosis of patients admitted to ICU.

关 键 词：危重病 急性生理学和慢性健康状况评分Ⅱ 血清胱抑素C 预后 

分 类 号：R449[医药卫生—诊断学]