血清胱抑素C、尿微量蛋白联合检测在万古霉素致早期肾损害中的应用  

Application in combined measurement of serum levels of cystatin C and urinary microproteins in patients with early renal injury caused by vancomycin

作　　者：李瑾[1] 殷少军[1] 李微[1] 陈维杰[1] 张毅琴[1] 陆卫东[1] 沈瑾[1] 董福轮[1] 

机构地区：[1]同济大学附属第十人民医院老年科,上海市200072

出　　处：《实用药物与临床》2012年第5期276-278,共3页Practical Pharmacy and Clinical Remedies

基　　金：上海市干部保健局科研基金资助项目(2011GB24)

摘　　要：目的探讨血清胱抑素C、尿微量蛋白(β2-微球蛋白、α1-微球蛋白、转铁蛋白、微量白蛋白)联合检测在万古霉素致早期肾损害中的临床价值。方法 40例耐甲氧西林金黄色葡萄球菌(MRSA)肺部感染患者,应用万古霉素治疗前后联合检测血清胱抑素C、尿微量蛋白的变化。结果 40例MRSA肺部感染患者应用万古霉素治疗后,血清胱抑素C、尿微量蛋白阳性率明显高于血肌酐、尿素氮和尿常规阳性率(P均<0.05)。老年患者万古霉素治疗后血清胱抑素C、尿微量蛋白阳性率明显高于中青年患者(P均<0.05)。结论老年人应用万古霉素较为安全,血清胱抑素C、尿微量蛋白联合检测可早期发现万古霉素所致肾损害。Objective To investigate the clinical value of combined measurement of serum levels of cystatin C and urinary microproteins（β2-MG,α1-MG,TRF and mAlb）in patients with early renal injury caused by vancomycin.Methods Changes of serum cystatin C and urinary microproteins were combined measured in 40 patients with pulmonary infection of methicillin resistant staphylococcus aureus（MRSA）before and after treatment.Results The positive rate of serum cystatin C and urinary microproteins were significantly higher than those of serum creatinine,blood urea nitrogen and routine urine test（P〈0.05）.The positive rates of serum cystatin C and urinary microproteins in elderly patients were significantly higher than those of the younger patients（P all0.05）.Conclusion Application of vancomycin in elderly patients with pulmonary infection by MRSA is safe.Combined measurement of the serum levels of cystatin C and urinary microproteins can early detect the renal injury by vancomycin.

关 键 词：万古霉素 肾功能 胱抑素C 尿微量蛋白 

分 类 号：R96[医药卫生—药理学]