血清同型半胱氨酸和胱抑素C联合尿微量白蛋白检测诊断重度烧伤患者早期肾损伤  

Significance of joint detection of serum homocysteine,cystatin C and urinary micro-albuminuria in diagnosis of early renal damage caused by severe burn

作　　者：王海滨[1] 顾春瑜[1] 石新慧[1] 

机构地区：[1]解放军总医院第一附属医院检验科,北京100048

出　　处：《中国临床医生杂志》2014年第12期30-32,共3页Chinese Journal For Clinicians

基　　金：国家重大科学仪器设备开发专项(编号:2013YQ190467070)

摘　　要：目的探讨血清同型半胱氨酸(HCY)、胱抑素C(Cys C)及尿微量白蛋白(m Alb)在重度烧伤患者中含量的变化及其临床意义。方法选取既往无肾病史烧伤患者110例,根据烧伤面积(BSA)分轻中度烧伤组、重度烧伤及时复苏组(4小时内复苏)、重度烧伤延迟复苏组(>4小时复苏)及52例体检健康人群作为对照组。采用循环酶法测定HCY,两点终点法测定Cys C,免疫比浊法测定尿m Alb。结果重度烧伤及时复苏组血清内HCY、Cys-C和m Alb含量明显高于对照组和轻中度烧伤组,而重度烧伤延迟复苏组内HCY、Cys C和m Alb含量分别是及时复苏组1.3倍、2.1倍和1.8倍,差异有显著性。同时三项指标联合检测的敏感性明显高于单项指标检测。结论 HCY、Cys C和尿m Alb可作为早期诊断重度烧伤引起的肾损伤较敏感的指标;联合检测能大大提高检测阳性率,在诊断重度烧伤引起早期肾损伤中具有显著的临床意义。Objective To explore the diagnostic significance of the joint detection of serum homocysteine （HCY）, Cystatin C （ Cys-C ） and urinary microalbuminuria （ mALB ） in early renal damage triggered by severe burn. Method According to burn surface area,110 burn patients without kidney disease are divided into slight-moderate group （33 patients）,instant recovery group （38 patients）or delayed recovery groups（40 patients）. 52 healthy vol-unteers were enrolled as control group. The levels of homocysteine were determined by enzymatic cycle method, while contents of Cystatin C were determined by two-point end assay, and microalbuminuria was sxexamined with immunoturbidimetric assay. Result The levels of HCY, Cys-C and mALB significantly increased in severe burn and instant recovery group compared to control group and slight-moderate group. The amounts of HCY, Cys-C and mALB in severe burn and delayed recovery group were 1. 3, 2. 1, and 1. 8 times of those in instant recovery group, respectively. The sensitivity of joint detection of these 3 indexes in diagnosis of early rental damage are obviously improved compared to single index detection. Conclusion HCY, Cys-C and mALB can act as sensitive indicators to diagnose early rental damage caused by severe burn. Combined detection can greatly increase the sensitivity, which is important in monitoring the occurrence of early nephropathy caused by severe burn.

关 键 词：半胱氨酸 胱抑素C 微量白蛋白 烧伤 肾脏疾病 

分 类 号：R446.1[医药卫生—诊断学]