血浆胱抑素C在对比剂肾病早期诊断中的价值  

The clinical value of serum cystatin C as early predictor of contrast induced nephropathy in patients

作　　者：杨林飞[1] 孙桂兰[1] 张婷[1] 

机构地区：[1]安徽省合肥市第二人民医院心血管内科,230012

出　　处：《安徽医学》2015年第7期809-812,共4页Anhui Medical Journal

摘　　要：目的探讨血浆胱抑素C(Cys C)在对比剂肾病(CIN)早期诊断中的临床意义。方法选择110例患者为研究对象,将其分为CIN组与非CIN组。所有患者于冠脉造影术前24小时、造影术后24小时和48小时抽血检测血清Cys C、血肌酐(Scr)、β痕迹蛋白(BTP)和根据MDRD公式计算肾小球滤过率(GFR)。结果 1CIN发病率为10.9%;2CIN组血浆Cys C、BTP、Scr、e GFR等指标造影后各时间点明显升高,均明显高于造影前以及非CIN组相应时间点的水平(P<0.05)。非CIN组血浆Cys C在造影后升高,24小时明显高于造影前水平(P<0.05);BTP在造影后升高,各时间点均高于造影前水平(P<0.05)。3与CIN有关指标的单因素及多因素logistic回归分析结果显示:仅血浆Cys C(OR=8.451,P=0.040)进入回归方程,与CIN密切相关,有预测价值。结论血浆Cys C可作为早期诊断CIN的敏感指标。Objective To study the clinical value of cystatin C( Cys C) as early predictor of contrast induced nephropathy( CIN) in patients. Methods Totally 100 patients were admitted and divided into CIN group and non -CIN group. Cys C, beta -trace protein (BTP), serum creatinine(Scr), and estimated glomerular filtration rate(eGFR)were measured in 24h before and 24 h, 48 h after the angi-ography, respectively. Results ①The prevalence of CIN was 10. 9%.②The Cys C, BTP, Scr and eGFR level reached the peak in 24 h and began to decrease 48 h after the angiography in CIN group, and it was significantly higher than those before contrast injection of CIN group and those in 24,48 h after contrast injection of non-CIN group, respectively(P<0. 05). Serum BTP level in non-CIN group showed significant difference between before and after contrast injection at 24h, 48h (P<0. 05). There was significant difference in Cys C level be-fore and after contrast injection at 24,48 h in non-CIN group (P<0. 05). ③Univariate and multivariate logistic regression analyses re-vealed that the serum Cys C level was the only independent variable factor in detecting CIN (Cys C:OR=8. 451, P=0. 040). Conclusion Cystatin C is useful for predicting the occurrence of CIN.

关 键 词：血浆胱抑素C β痕迹蛋白 冠状动脉造影 对比剂肾病 

分 类 号：R692[医药卫生—泌尿科学]