血清铁蛋白、甲状旁腺激素、血肌酐及血尿素水平在急性肾衰竭患者诊疗中的临床价值  

Clinical value of serum ferritin,parathyroid hormone,serum creatinine and blood urea nitrogen levels in the diagnosis and treatment of patients with acute renal failure

作　　者：刘锦霞 马轶[1] 余红[1] 廖芮 王铁梅 罗丹[1] 苏婕 张家宁 李丹[2] 王娟 王玺 LIU Jinxia;MA Yi;YU Hong;LIAO Rui;WANG Tiemei;LUO Dan;SU Jie;ZHANG Jianing;LI Dan;WANG Juan;Wang Xi(Department of Critical Care Medicine,Chengdu Third People′s Hospital,Chengdu Sichuan 614000,China)

机构地区：[1]成都市第三人民医院重症医学科,四川成都614000 [2]成都市第二人民医院重症医学科一病区,四川成都610031 [3]成都双楠医院老年病区,四川成都614000

出　　处：《中国急救复苏与灾害医学杂志》2024年第7期931-934,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：四川省医学会(宜昌人福)专项课题[编号:2016ZZ002(YCRF)]。

摘　　要：目的 分析血清铁蛋白(SF)、甲状旁腺激素(PTH)、血肌酐(Cr)及血尿素(BUN)水平在急性肾衰竭(ARF)患者诊疗中的临床价值。方法 选取2021年4月—2023年4月成都市第三人民医院重症监护病房(ICU)≥24 h的患者126例为研究对象,依据住院期间是否发生ARF将患者分为ARF组(n=51)和非ARF组(n=75),按临床分期将ARF组患者分为Ⅰ期、Ⅱ期和Ⅲ期,各15例、18例、18例,并选取同期健康体检者50例作为对照组,比较各组血清SF、PTH、Cr、BUN水平,采用ROC曲线分析SF、PTH、Cr、BUN水平对ARF的诊断效能,采用Spearman相关分析SF、PTH、Cr、BUN水平与ARF临床分期的相关性。结果 ARF组血清SF、PTH、Cr及BUN水平高于非ARF组和对照组,非ARF组血清SF、PTH、Cr及BUN水平高于对照组(P<0.05)。Ⅲ期ARF患者血清SF、PTH、Cr及BUN水平高于Ⅱ期和Ⅰ期,Ⅱ期ARF患者血清SF、PTH、Cr及BUN水平高于Ⅰ期(P<0.05)。ROC曲线分析显示,血清SF、PTH、Cr及BUN水平联合诊断ARF的敏感度为90.20%,AUC为0.863,均高于单独检测(P<0.05)。Spearman相关分析显示,血清SF、PTH、Cr、BUN水平与ARF临床分期呈正相关性(r=0.431、0.440、0.419、0.408,P<0.05)。结论 血清SF、PTH、Cr、BUN水平联合诊断ARF的价值较高,并可反映ARF病情严重程度,为临床治疗提供参考。Objective To analyze the clinical value of serum ferritin(SF),parathyroid hormone(PTH),serum creatinine(Cr) and blood urea nitrogen(BUN) levels in the diagnosis and treatment of patients with acute renal failure(ARF).Methods A total of 126 patients admitted to our intensive care unit(ICU) for ≥24 hours from April 2021 to April 2023were selected as the study subjects.They were divided into ARF group(n=51) and non-ARF group(n=75) according to whether the patient had ARF during hospitalization.In the ARF group,there were 15 patients at stageⅠ,18 patients at stageⅡand 18 patients at stageⅢ.At the same time,50 healthy individuals were selected as the control group.Serum SF,PTH,Cr and BUN levels in different groups were compared.The diagnostic performance of SF,PTH,Cr and BUN levels for ARF was analyzed using the ROC curve.Spearman correlation analysis was conducted to identify the correlation between SF,PTH,Cr and BUN levels and the clinical stage of ARF.Results Serum SF,PTH,Cr and BUN levels decreased in order from the ARF group,the non-ARF group to the control group(P<0.05).For patients with ARF,serum SF,PTH,Cr and BUN in stage Ⅲ stage Ⅱ,and stage Ⅰ decreased in order(P<0.05).ROC curve analysis showed that the sensitivity and AUC of combined diagnosis of ARF with serum SF,PTH,Cr and BUN levels were 90.20% and 0.863,higher than those of single diagnosis(P<0.05).Spearman correlation analysis found that serum SF,PTH,Cr and BUN levels were positively correlated with the clinical stage of ARF(r=0.431,0.440,0.419,0.408,P<0.05).Conclusion The combined diagnosis of ARF using serum SF,PTH,Cr,and BUN levels has a high clinical value and can reflect the severity of ARF,providing reference for clinical treatment.

关 键 词：急性肾衰竭 铁蛋白 甲状旁腺激素 血肌酐 血尿素 

分 类 号：R692[医药卫生—泌尿科学]