PCT、CysC联合检测在重症肺炎患者急性肾损伤预测中的临床价值  

Clinical value of combined detection of PCT and CysC in predicting acute kidney injury in patients with severe pneumonia

作　　者：蒋志敏[1] 吴林军[1] 雷建东[1] 季沙 钱建冬 JIANG Zhi-min;WU Lin-jun;LEI Jian-dong;JI Sha;QIAN Jian-dong(Department of Laboratory,Leshan Hospital of Traditional Chinese medicine,Leshan,Sichuan 614000,China)

机构地区：[1]乐山市中医医院检验科,四川乐山614000

出　　处：《临床肺科杂志》2022年第4期512-515,519,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨降钙素原(PCT)、胱抑素C(CysC)联合检测对重症肺炎(SP)合并急性肾损伤(AKI)的预测价值。方法选择本院重症监护室2017年2月至2021年2月期间收治的SP患者110例。将110例SP患者分为AKI组和无AKI组,比较两组临床资料,比较AKI组不同KIDGO分期患者血清PCT、CysC水平,分析血清PCT、CysC与KDIGO分期的相关性,多因素Logistic回归分析SP患者合并AKI的危险因素,绘制受试者工作特征(ROC)曲线,评价PCT、CysC对SP患者发生AKI的预测价值。结果AKI组住院时间长于无AKI组(P<0.01),APACHEⅡ评分、SOFA评分及血清Cr、UA、PCT、CysC水平均高于无AKI组(P<0.01);多因素logistic回归分析显示PCT、CysC是SP患者发生AKI的独立危险因素;AKI组患者血清PCT、CysC水平随着KDIGO分期的增加而逐渐增加(P<0.01),组间两两比较差异均有统计学意义(P<0.05);AKI组血清PCT、CysC水平均与KDIGO分期呈正相关(r=0.779、0.472,P均<0.01);ROC曲线显示PCT、CysC联合检测预测价值分别优于PCT、CysC单独检测(Z=2.941、2.478,P均<0.05),差异均有统计学意义。结论PCT、CysC是SP患者发生AKI的独立危险因素,PCT、CysC联合检测对SP发生AKI的具有较高的预测价值。Objective To explore the predictive value of combined detection of procalcitonin(PCT)and cystatin C(CysC)in severe pneumonia(SP)complicated with acute kidney injury(AKI).Methods 110 patients with SP were selected in ICU of our hospital from February,2017 to February,2021,and they were divided into the AKI group and the non AKI group.The clinical data of the two groups were compared.The levels of serum PCT and CysC of the AKI group in different KDIGO stages were compared.The correlation of serum PCT and CysC with KDIGO stages was analyzed.The risk factors of AKI in SP patients were analyzed by multivariate logistic regression.The receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of PCT and CysC levels for AKI in SP patients.Results The duration of hospital stay was longer in the AKI group than in the non AKI group(P<0.01),acute physiology and chronic health evaluation scoring system Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score and serum Cr,UA,PCT,CysC levels were higher in the AKI group than in the non AKI group(P<0.01).Multivariate logistic regression analysis showed that the levels of PCT and CysC were independent risk factors for AKI in SP patients.The levels of serum PCT and CysC of the AKI group increased gradually with the increase of KDIGO stage(P<0.01),and the differences between the two groups were statistically significant(P<0.05).Serum PCT and CysC levels were positively correlated with KIDGO stage in the AKI group(r=0.779,0.472,P<0.01).ROC curve showed that the predictive value of combined detection of PCT and CysC was better than that of single detection of PCT and CysC(z=2.941,2.478,all P<0.05).Conclusion PCT and CysC are independent risk factors for AKI in SP patients.The combined detection of PCT and CysC has a high predictive value for AKI in SP patients.

关 键 词：重症肺炎 急性肾损伤 降钙素原 胱抑素C 预测 

分 类 号：R563.1[医药卫生—呼吸系统]