血清TFF3和Cys-C联合检测对体外冲击波碎石术后肾功能损伤的评估价值  

Value of combined detection of serum TFF3 and Cys-C in evaluating renal function damage after extracorporeal shock wave lithotripsy

作　　者：倪建华[1] 朱江波[1] 章庆华[1] 施展[1] 王建新 张飞 NI Jian Hua;ZHU Jiangbo;ZHANG Qinghua(First People's Hospital of Taizhou,Zhejiang 318020,China)

机构地区：[1]浙江省台州市第一人民医院,台州318020

出　　处：《浙江创伤外科》2020年第3期413-415,共3页Zhejiang Journal of Traumatic Surgery

摘　　要：目的探讨血清三叶因子3(TFF3)和胱抑素(Cys-C)联合检测对体外冲击波碎石术(ESWL)后肾功能损伤的评估价值。方法选取85例首次诊断为复杂性肾结石的患者,接受ESWL治疗,收集所有患者基本资料,检测患者术前及术后2、12、24、48、72小时血清中TFF3、Cys-C、SCr,采用Pearson进行相关分析,ROC曲线确定TFF3和Cys-C对诊断肾功能损伤的最佳截断值、敏感度和特异度。结果复杂性肾结石患者ESWL前后TFF3、Cys-C及eGFR水平变化随时间呈现一定规律:TFF3和Cys-C在术后2小时开始升高,在术后24小时之间达到高峰,随后浓度逐渐下降,在术后72小时基本恢复到术前水平。eGFR在术后2小时开始降低,在术后24小时之间达到高峰。血清TFF3和Cys-C水平与eGFR呈负相关(P<0.05);血清TFF3和Cys-C诊断肾功能损伤的ROC曲线分别为0.883和0.744;TFF3单独诊断肾功能损伤的灵敏度和特异度依次为83.52%和74.16%,均高于Cys-C的73.22%和54.63%;采用联合诊断后灵敏度和特异度均提高(P<0.05)。结论ESWL对肾功能有一定损伤,血清TFF3和Cys-C水平在ESWL术后均有一定程度的提高,两者联合检测可以提高诊断价值。Objective To investigate the value of combined detection of serum TFF3 and Cys-C in evaluating renal function damage after extracorporeal shock wave lithotripsy(ESWL).Methods Eighty-five patients with complex renal calculi first diagnosed in our hospital were treated with ESWL.The basic data of all patients were collected.Blood samples were collected before and 2,12,24,48 and 72 hours after operation.TFF3,Cys-C and SCr in serum were detected.Pearson test was used for correlation analysis.The working characteristics(RFOC curve)of subjects were drawn to determine the best truncation value,sensitivity and specificity of TFF3 and Cys-C for the diagnosis of renal function injury.Results The changes of TFF3,Cys-C and eGFR levels in patients with complex renal calculi before and after ESWL showed a certain regularity with time.TFF3 and Cys-C began to increase at 2 hours after operation,peaked at 24 hours after operation,then gradually decreased,and basically recovered to the preoperative level at 72 hours after operation.The eGFR began to decrease at 2 hours after operation,peaked at 24 hours after operation,and then increased gradually,but did not return to the preoperative level.Serum TFF3 and Cys-C levels were negatively correlated with eGFR(P<0.05).ROC curves of serum TFF3 and Cys-C in diagnosis of renal function injury were 0.883 and 0.744 respectively.The sensitivity and specificity of TFF3 alone in diagnosis of renal function injury were 83.52%and 74.16%respectively,which were higher than those of Cys-C 73.22%and 54.63%.The sensitivity and specificity of combined diagnosis were improved(P<0.05).Conclusion ESWL has certain impairment on renal function.Serum TFF3 and Cys-C levels have increased to a certain extent after ESWL,suggesting that it has certain diagnostic value for renal function damage after ESWL,and joint detection can improve the diagnostic value.

关 键 词：三叶因子3 胱抑素C 肾功能损伤 

分 类 号：R699.2[医药卫生—泌尿科学]