血清胱抑素C在评估DebakeyⅠ型主动脉夹层术后急性肾损伤中的价值  

Significance of serum cystatin C in evaluating postoperative acute kidney injury in Debakey TypeⅠ aortic dissection

作　　者：李萌[1] 时高峰[1] 李玉环[2] 李月考[1] 

机构地区：[1]河北医科大学第四医院CT磁共振科,河北石家庄050011 [2]石家庄市第二医院放射科

出　　处：《中国急救医学》2016年第10期928-930,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨血清胱抑素c在评估DebakeyⅠ型主动脉夹层术后急性肾损伤中的价值，寻求可以早期反映主动脉夹层急性肾损伤的敏感指标。方法收集2014-10～2016—04在我院确诊并且接受手术治疗的32例DebakeyⅠ型主动脉夹层患者术后血清胱抑素C及围手术期血肌酐，根据KDIGO急性肾损伤分期标准以血肌酐水平将患者分为肾损伤组和非肾损伤组，将两组患者的性别、年龄、体质量指数、发病时间、术中输红细胞量、主动脉阻断时间、体外循环转流总时间和深低温停循环时间作为一般资料进行分析。将所有患者血清胱抑素C和血肌酐水平进行统计并采用x2检验，进行线性趋势检验。结果两组患者性别、年龄、发病时间、体质量指数、术中输红细胞量、主动脉阻断时间、体外循环转流总时间和深低温停循环时间比较差异均有统计学意义（P〈0．05）。血清胱抑素C及血肌酐升高水平有相关性（X2=13．23，v=3，P〈0．005），并分解得出线性回归分量x2回归=11．29，v回归=1，P〈0．005，偏离线性回归分量x2 偏离=1．93，v偏离=2，P〉0．05。结论主动脉夹层患者血清胱抑素C与血肌酐升高水平具有相关性，而且是线性相关。血清胱抑素c可以作为提示急性主动脉夹层患者发生急性肾损伤的敏感实验室指标。Objective To explore the significance of serum cystatin C in evaluating the development of postoperative acute kidney injury in Debakey Type Ⅰ aortic dissection, and to search for a sensitive indicator for acute kidney injury during early stages of aortic dissection. Methods Postoperafiveserum cystatin C levels and perioperative serum creatinine levels were collected from 20 patients who were confirmed with Debakey Type Ⅰ aortic dissection and received surgical treatment in our hospital from October 2014 to April 2016. According to the KDIGO staging criteria for acute kidney injury, patients were assigned to the kidney injury group or non - kidney injury group based on the serum creatinine level, for analysis of the general indicators including patient gender, age, time of disease onset, BMI, intraoperative RBC transfusion volume, aortic cross -clamping time, total CPB time and deep hypothermic circulatory arrest （DHCA） time. Serum cystatin C and serum creatinine levels were collected from all the patients and subject to ~2 test for linearity. Results There were statistically significant differences between the two groups in age, gender, time of disease onset, BMI, intraoperative RBC transfusion volume, aortic cross - clamping time, total CPB time or DHCA time （ P 〈 0.05 ）. Analysis of correlation between serum cystatin C level and serum creatinine increase derived the X2 = 13.23, v = 3, P 〈 0. 005, and regression analysis derived the linear regression component x2 reg = 11. 29, Vreg = 1, P 〈 0.005 and the deviation from linear regression component X2 dev = 1.93, v dev = 2, P 〉 0.05. Conclusion In patients with aortic dissection, perioperative serum cystatin C level and serum creatinine increase showed linear correlation. Serum cystatin C could provide a sensitive laboratory indicator for acute kidney injury in aortic dissection.

关 键 词：主动脉夹层 急性肾损伤 血清胱抑素C 血肌酐 

分 类 号：R543.16[医药卫生—心血管疾病]