CysC和RBP水平评价血清肌酐参考范围的截断值研究  

Study on CysC and RBP levels for evaluating cut-off values of serum creatinine reference range

作　　者：蒋慧晖 张帆[2] 满雪芹 燕玲 李庆琳[3] 李慧[3] 陈维贤[3] 周华[3] IANG Huihui;ZHANG Fan;MAN Xueqin;YAN Ling;LI Qinglin;LI Hui;CHEN Weixian;ZHOU Hua(Department of Hematology Medicine Laboratory,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 401336,China;College of Public Health,Chongqing Medical University,Chongqing 400016,China;Department of Clinical Laboratory,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院血液内科实验室,401336 [2]重庆医科大学公共卫生学院,400016 [3]重庆医科大学附属第二医院检验科,400010

出　　处：《重庆医学》2019年第13期2224-2226,共3页Chongqing medicine

基　　金：重庆市市级临床重点专科项目[渝卫(2013)52号]

摘　　要：目的探讨血清胱抑素C(CysC)和视黄醇结合蛋白(RBP)水平评价血清肌酐(Scr)参考范围调整的临床价值。方法对重庆医科大学附属第二医院2017年12月21日至2018年4月25日体检中心20 126例病例Scr测定情况进行回顾性分析,1 874例同时有Scr和CysC结果,对372例按照WS/T 404参考区间(新参考区间)Scr升高但无CysC结果的样本重新测定CysC和RBP。结果新参考区间更加适用于临床95%置信区间。采用CysC升高为评价肾损伤的参考方法,以新参考区间为截断值时,Scr阳性与CysC阳性差异有统计学意义(χ^2=198.648,P=0.000);以132.3μmol/L(旧参考区间上限)为截断值时,Scr阳性与CysC阳性差异有统计学意义(χ^2=82.337,P=0.000)。以新参考区间为截断值的Scr与CysC的相关性较旧参考区间更好。当Scr>108μmol/L时,RBP才出现升高,存在正相关。结论新参考区间的截断值更加有助于临床辅助诊断。Objective To investigate the clinical value of CysC and RBP levels for evaluating the adjustment of the serum creatinine reference range.Methods The serum creatinine detection situation of 20 126 cases in the Second Affiliated Hospital of Chongqing Medical University from December 21,2017 to April 25,2018 was retrospectively analyzed,in which 1 874 cases simultaneously had serum Scr and CysC detection results,and 372 cases with Scr increaing but without CysC results redetected the CysC and RBP levels according to the new reference range of WS/T 404.Results The new reference range was more suitable for clinical 95%confidence range.By adopting the CysC level increasing as the reference method for evaluating the renal injury and new reference interval as the cut-off value,the difference in Scr and CysC positive had statistical significance(χ^2=198.648,P=0.000).When with 132.3μmol/L(old reference interval)as the cut-off value,the difference in Scr and Cys C positive was statistically significant(χ^2=82.337,P=0.000).With the new reference interval as the cut-off value,the correlation between Scr and CysC was better than the old reference interval.When Scr>108μmol/L,RBP appeared increasing and showed the positive correlation.Conclusion The cut-off value of new reference interval is more conducive to clinical auxiliary diagnosis.

关 键 词：参考值 肌酸酐 半胱氨酸蛋白酶抑制剂 

分 类 号：R446.112[医药卫生—诊断学]