尿微量白蛋白和血清胱抑素C在造影剂肾病中的联合诊断价值  

Diagnosis Value of Urinary Microalbumin with Serum Cystatin C Combined Contrast-Induced Nephropathy(CIN)in Patients with Coronary Heart Disease

作　　者：赵永伟 顾明[2] ZHAO Yongwei;GU Ming(Clinical Medicine College of Beihua University,Jilin 132013,China;Affiliated Hospital of Beihua University,Jilin 132011,China)

机构地区：[1]北华大学临床医学院,吉林吉林132013 [2]北华大学附属医院,吉林吉林132011

出　　处：《北华大学学报（自然科学版）》2020年第5期634-638,共5页Journal of Beihua University（Natural Science）

基　　金：吉林省教育厅科学技术研究项目(2015140).

摘　　要：目的探讨尿微量白蛋白和血清胱抑素C(Cys-C)在冠心病行介入手术后并发造影剂肾病(CIN)患者的早期诊断价值.方法选取102例因冠心病行支架置入术治疗的患者,检测患者尿微量白蛋白、血清肌酐(Scr)及Cys-C水平,观察造影剂肾病的发生情况,探讨尿微量白蛋白、血清Scr以及Cys-C三者之间的关联性.结果102例经冠脉支架植入术患者CIN的发生率为16.66%.治疗后,CIN患者尿微量白蛋白、血清Scr及Cys-C水平与治疗前比较明显增高(P<0.05),尿微量白蛋白、血清Scr以及Cys-C呈明显正相关性(r=0.422,P<0.05;r=0.218,P<0.05).此外,尿微量白蛋白和Cys-C联合检测的灵敏度及特异度均高于单一检测(P<0.05).结论在冠心病行介入术后并发CIN的患者中尿微量白蛋白和Cys-C水平均显著升高,联合检测对早期识别及诊断CIN具有较高的灵敏度和特异度,可作为早期诊断CIN的首选检测指标.Objective To investigate clinical value of urinary microalbumin combined with serum cystatin C(Cys-C)in early diagnosis of contrast-induced nephropathy in patients with coronary heart disease.Method A total of 102 coronary heart disease patients with stent implantation were selected to observe incidence rate of contrast-induced nephropathy.Levels of urinary microalbumin,serum Cys-C and creatinine(Scr)were detected,and correlations between urinary microalbumin with serum Cys-C and Scr were analyzed.Results Incidence rate of contrast-induced nephropathy of 102 patients after stent implantation was 16.66%.After treatment,urinary microalbumin,serum Cys-C and Scr levels were significantly higher than those before treatment(P<0.05).Urinary microalbumin was positively correlated with serum Cys-C and Scr(r=0.422,P<0.05;r=0.218,P<0.05).Values of sensitivity and specificity of urinary microalbumin combined with serum Cys-C in early diagnosis of contrast-induced nephropathy in patients with coronary heart disease were significantly higher than those by urinary microalbumin or serum Cys-C and serum Scr detections only(P<0.05).Conclusion Urinary microalbumin and serum Cys-C levels are significantly higher in coronary heart disease patients with contrast-induced nephropathy,and combined detection has high sensitivity and specificity in early diagnosis of contrast-induced nephropathy in patients with coronary heart disease,therefore,it can be used as the first index for early diagnosis of contrast-induced nephropathy in patients with coronary heart disease.

关 键 词：冠心病 造影剂肾病 尿微量白蛋白 血清胱抑素C 血清肌酐 

分 类 号：R781.64[医药卫生—口腔医学]