尿肾损伤分子1和尿胱抑素C在重症监护室万古霉素肾损伤早期诊断中的作用  

Significance of urinary kidney injury molecule 1 and urinarycystatin C in early diagnosis of vancomycin- induced kidney injury in intensive care unit

作　　者：钟丹锋 宋于康 董平 

机构地区：[1]浙江省温岭市第一人民医院重症监护室,浙江温岭317500

出　　处：《中国临床药理学杂志》2016年第2期99-101,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察尿肾损伤分子1(KIM-1)和尿胱抑素C在重症监护室万古霉素肾损伤早期诊断中的作用。方法根据是否发生肾损伤,将180例使用万古霉素患者分成试验组32例(肾损伤)和对照组148例(非肾损伤),比较2组治疗前、治疗后6,12,24,48 h血肌酸酐、尿胱抑素、尿肾损伤分子1水平,并用受试者工作特征曲线分析尿肾损伤分子1和尿胱抑素C对重症监护室万古霉素肾损伤早期诊断的价值。结果试验组用药后48 h血肌酸酐显著高于对照组(P<0.05);试验组用药后12,24,48 h尿胱抑素C显著高于对照组(P<0.05);试验组用药后6,12,24,48 h尿肾损伤分子1均显著高于对照组(P<0.01)。尿胱抑素C和尿肾损伤分子1诊断万古霉素肾损伤受试者工作特征曲线下面积分别为0.783和0.884,敏感性分别为0.864和0.936,特异性分别为0.784和0.856。结论尿肾损伤分子1及尿胱抑素C可作为万古霉素肾损伤患者的早期诊断标志物,其中尿肾损伤分子1的诊断效能更高。Objective To explore the significance of urinary kidney injury molecule 1（ KIM- 1） and urinarycystatin C in early diagnosis of vancomycin- induced kidney injury. Methods A total of 180 patients given vancomycin were divided into kidney injury group（ n = 32） and non- kidney injury group（ n = 148） according to the occurrence of vancomycin- induced kidney injury. The difference of serum creatinine,urinary cystatin C,urinary KIM- 1 were observed before treatment,after 6,12,24,48 h treatment. And the reciver operating characteristic（ ROC）curve was used to explore the significance of urinary KIM- 1 and urinary cystatin C in early diagnosis of vancomycin- induced kidney injury. Results The urinary creatinine after 48 h treatment in the kidney injury group was significantly higher than that in the non- kidney injury group（ P〈0. 05）. The urinary cystatin C after 12,24,48 h treatment in the kidney injury group was significantly higher than that in the non- kidney injury group（ P〈0. 05）. The urinary KIM- 1 after 6,12,24,48 h treatment in the kidney injury group was significantly higher than that in the non- kidney injury group（ P〈0. 05）. The areas under the curve of urinary cystatin C and urinary KIM- 1 were respectively 0. 783 and0. 884, the sensitivity were respectively 0. 864 and 0. 936, thespecificity were respectively 0. 784 and 0. 856. Conclusions Urinary cystatin C and urinary KIM- 1 were helpful biomarkers for early diagnosis of vancomycin- induced kidney injury in patients,and the accuracy of urine KIM- 1 was better.

关 键 词：肾损伤分子1 胱抑素C 万古霉素 肾损伤 

分 类 号：R978.1[医药卫生—药品]