血清胱抑素C和Stevens-Cr方程估算肾小球滤过率早期诊断造影剂肾病  

Significance of joint detection of cystatin C and glomerular filtration rate calculated by Stevens-Cr equation in early diagnosis of contrast-induced nephropathy

作　　者：冯建启[1] 于芹慧 刁军[1] 巩雷[1] 蔡文标[1] 彭城[1] 祁春梅[1] 武维恒[1] 

机构地区：[1]徐州医学院第二附属医院心内科,江苏省徐州市221000

出　　处：《中国心血管病研究》2015年第10期921-924,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨经皮冠状动脉介入治疗前后测定血清胱抑素C,经Stevens-Cr方程估算肾小球滤过率对早期诊断造影剂肾病的临床意义.方法 选取2014年1～8月在我院行PCI的患者256例,其中22例术后出现造影剂肾病,设为CIN组,其余234例患者设为对照组.分别于术前及术后12 h、24h、48 h检测血肌酐、血清胱抑素C,经简化MDRD方程、Stevens-Cr方程估算肾小球滤过率,并进行比较.结果 术前CIN组肌酐、血清胱抑素C,经简化MDRD方程、Stevens-Cr方程估算出的肾小球滤过率与对照组相比未见统计学差异（P＞0.05）.术后24 h CIN组患者血肌酐水平开始升高,经简化MDRD方程估算出的肾小球滤过率减低明显,与术前及对照组相比差异有统计学意义（P＜0.01）.术后12 h CIN组患者血清胱抑素C水平开始升高,经Stevens-Cr方程估算出的肾小球滤过率减低明显,与术前及对照组相比差异有统计学意义（P＜0.05）.结论 血清胱抑素C、经Stevens-Cr方程估算出的肾小球滤过率可以反映早期肾功能损害的严重程度,可以作为造影剂肾病的检测指标.Objective To study the significance of joint detection of cystatin C （Cys C ） and glomerular filtration rate （eGFR） calculated by Stevens-Cr equation in early diagnosis of contrast-induced nephropathy（CIN ） after percutaneous coronary intervention （PCI）. Methods In 256 patients undergoing PCI, 22 patients had CIN （CIN group） and 234 patients had no CIN（control group）. Serum creatinine（Scr）, Cys C were detected before and 12 hours, 24 hours and 48 hours after PCI. eGFR were calculated by simplified MDRD equation and Stevens-Cr Equation respectively. Results There were no significant differences in Scr, Cys C and eGFR levels before PCI between CIN group and control group（P〉0.05 ）. The levels of Scr and eGFR calculated by simplified MDRD equation were significantly higher in CIN group than those in control group 24 hours after PCI（P〈0.01 ）, and were significantly higher than those before PCI in CIN group （P〈0.01）. The levels of Cys C and eGFR calculated by Stevens-Cr equation were significantly higher in CIN group than those in control group 12 hours after PCI （P〈 0.05）, and were significantly higher than those before PCI in CIN group（P〈0.05）. Conclusion Cys C and eGFR calculated by Stevens-Cr equation can be a reliable indicator for early impairment of renal function, and will be helpful for diagnosis of CIN.

关 键 词：造影剂肾病 肾小球滤过率 Stevens-Cr方程 

分 类 号：R692[医药卫生—泌尿科学]