347名飞行员血清胱抑素C与肾血流参数的相关性分析  

Correlation analysis of serum cystatin C and renal blood flow parameters in 347 pilots

作　　者：祝玉慧 韩蕊 郑晓慧 张巧莲 史伟伯 朱莹 谢颖坤 Zhu Yuhui;Han Rui;Zheng Xiaohui;Zhang Qiaolian;Shi Weibo;Zhu Ying;Xie Yingkun(Care ward of the 960 Hospital of Joint Logistics Support Force,Jinan 250031,China;Department of Ultrasound Medicine,Afiliated Hospital of Heze Medical College,Heze 274005,China;Department of Specific Diagnosis,the 960th Hospital of Joint Logistics Support Force,Jinan 250031,China)

机构地区：[1]联勤保障部队第九六〇医院干部病房,济南250031 [2]菏泽医学专科学校附属医院超声医学科,菏泽274005 [3]联勤保障部队第九六〇医院特诊科,济南250031

出　　处：《中华航空航天医学杂志》2024年第1期23-28,共6页Chinese Journal of Aerospace Medicine

摘　　要：目的探讨健康飞行员血清胱抑素C(cystatin C,Cys-C)水平与肾血流参数的关系,为飞行员早期肾损伤提供预警信息。方法以2019年7月至2021年12月于联勤保障部队第九六〇医院空勤科行年度体检的347名军事飞行员为研究对象,选取同期同年龄段347名健康查体者作为对照组。采用彩色多普勒血流成像定性分析飞行员肾动脉血流,包括主肾动脉、段动脉和叶间动脉的最大收缩期峰速(peak systolic velocity,PSV)、舒张期最低血流速度(end-diastolic blood flow velocity,EDV)、阻力指数(resist index,RI),测定所有受检者的血清尿素氮、肌酐和尿酸指标。飞行员组与对照组按照年龄分为21~30岁、31~40岁、41~50岁组;按照血清Cys-C水平的中位数,将飞行员分为高Cys-C组和低Cys-C组。比较2组的Cys-C水平和肾血流参数,分析飞行员Cys-C水平与肾血流参数的相关性。结果各年龄段飞行员组的血清Cys-C水平与对照组比较差异均无统计学意义(P均>0.05)。各年龄段飞行员Cys-C水平差异有统计学意义(H=8.24,P=0.045),各年龄段对照组受检者Cys-C水平差异无统计学意义(P>0.05)。高Cys-C组飞行员肌酐清除率、尿酸水平高于低Cys-C组,差异有统计学意义(Z=-4.17、-2.98,P<0.001、=0.003)。高Cys-C组飞行员主肾动脉EDV小于低Cys-C组,差异有统计学意义(t=4.82,P=0.021);高Cys-C组飞行员肾叶间动脉EDV小于低Cys-C组,差异有统计学意义(Z=-5.48,P=0.030)。相关性分析显示,飞行员Cys-C水平与年龄、飞行时间和尿酸呈正相关(r=0.381、0.165、0.359,P=0.001、0.002、0.003);Cys-C水平与主肾动脉、叶间动脉EDV呈负相关(r=-0.306、-0.321,P=0.048、0.024),与主肾动脉RI呈正相关(r=0.417,P=0.029)。结论飞行员血清Cys-C与主肾动脉、叶间动脉EDV及主肾动脉RI相关,可以在一定程度上反映肾功能的基础信息,有望为其早期肾损伤提供预警信息。Objective To provide warning information for early renal injury in pilots by investigating the relationship between serum cystatin C(Cys-C)level and renal blood flow parameters in healthy pilots.Methods A total of 347 military pilots who underwent annual physical examination in the Air Service Department of the 960th Hospital of Joint Logistics Support Force from July of 2019 to December of 2021 were selected as the pilot group,and 347 healthy subjects who were in same age span and examined at same period were selected as the control group.Color Doppler flow imaging was used to qualitatively analyze renal artery blood flow parameters,including the peak systolic velocity(PSV),end-diastolic blood flow velocity(EDV)and resistance index(RI)of the main renal artery,segmental artery and interlobar arteries.The serum urea nitrogen,serum creatinine and uric acid of subjects were measured.Both pilot group and the control group were divided into 21-30 years old,31-40 years old and 41-50 years old groups.According to the median level of serum Cys-C,the pilots were divided into high Cys-C group and low Cys-C group.The Cys-C level and renal blood flow parameters of each group were compared,and the correlation between Cys-C level and renal blood flow parameters of pilots was analyzed.Results There were no significant differences on serum Cys-C level between the pilot group and the control group at all ages(all P>0.05).There was a significant difference on Cys-C levels among the pilots of different ages(H=8.24,P=0.045).There was no significant difference in Cys-C levels among control groups at different ages(P>0.05).The levels of endogenous creatinine clearance and uric acid in the high Cys-C group were higher than those in the low Cys-C group,and the differences were significant(Z=-4.17,-2.98,P<0.001,=0.003).The EDV of main renal artery in high Cys-C group was lower than that in low Cys-C group,and the difference was significant(t=4.82,P=0.021).The EDV of interlobar arteries in high Cys-C group was lower than that in low Cys-C

关 键 词：肾循环 血清 胱抑素C 飞行员 

分 类 号：R85[医药卫生—航空、航天与航海医学]