血清胱抑素C、尿微量白蛋白及β2-微球蛋白检测对急性肾损伤诊断及预后的意义
Significance of the serum cystatin C,microdose albumin and β2-microglobulin detection in the diagnosis and prognosis of the acute kidney injury
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摘要: 目的：探讨血清胱抑素C（CysC）、尿微量白蛋白（mAlb）及β2-微球蛋白（β2-MG）检测对急性肾损伤（AKI）病人病情及预后判断的意义。方法：AKI病人97例根据AKI分期分成AKI 1期组45例，AKI 2期组27例，AKI 3期组25例，同时选取同期55名健康体检者作为对照组。对各组血清CysC、尿mAlb及β2-MG进行检测，同时对各组进行急性生理与慢性健康评估Ⅱ（APACHEⅡ）评分。结果：4组的血清CysC、尿mAlb、尿β2-MG水平差异有统计学意义（P<0.01），AKI各组的血清CysC、尿mAlb、尿β2-MG水平均明显高于对照组（P<0.01），AKI2组及AKI3组均明显高于AKI1组（P<0.01），AKI3组明显高于AKI2组（P<0.01）。AKI各组APACHEⅡ评分差异有统计学意义（P<0.01），AKI2组及AKI3组均明显高于AKI1组（P<0.01），AKI3组明显高于AKI2组（P<0.01）；血清CysC、尿mAlb、尿β2-MG水平与APACHEⅡ评分均存在显著正相关关系（P<0.01）；血清CysC、尿mAlb、尿β2-MG联合检测AKI阳性检出率明显高于这3项指标单独检测时的阳性检出率（P<0.05）；AKI病人中存活组病人的血清CysC、尿mAlb、尿β2-MG水平及APACHEⅡ评分均明显低于死亡组（P<0.01）。结论：血清CysC、尿mAlb及β2-MG与AKI病人的病情严重程度及预后密切相关，可作为AKI病人病情及预后评估的重要指标。Abstract: Objective:To investigate the significance of the serum cystatin C(CysC),microdose albumin(mAlb) and β2-microglobulin(β2-MG) detection in the diagnosis and prognosis of the acute kidney injury(AKI).Methods:Ninety-seven AKI patients were divided into the stage AKI 1(45 cases),stage AKI 2(27 cases) and stage AKI 3(25 cases),and 55 healthy people were set as the control group.The levels of CysC,mAlb and β2-MG were detected in each group,and the scores of acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) in all cases were evaluated.Results:The differences of the serum levels of CysC,mAlb and urine β2-MG between fours groups were statistically significant(P<0.01),the levels of CysC,mAlb and urine β2-MG in AKI groups were significantly higher than those in control group(P<0.01),the levels of CysC,mAlb and urine β2-MG in AKI 2 and AKI 3 groups were significantly higher than those in AKI 1 group(P<0.01),and the levels of CysC,mAlb and urine β2-MG in AKI 3 groups were significantly higher than those in AKI 2 group(P<0.01).The differences of the scores of APACHEⅡ between four groups were statistically significant(P<0.01),the scores of APACHEⅡ in AKI 2 and AKI 3 groups were significantly higher than those in AKI 1 group(P<0.01),and the score of APACHEⅡ in AKI 3 group was significantly higher than that in AKI 2 group(P<0.01).The levels of serum CysC,mAlb and urine β2-MG were significantly positive correlated with APACHEⅡ score(P<0.01).The positive rate of the combined detection of serum CysC,mAlb and β2-MG in the diagnosis of AKI was significantly higher than that of the independent 3 indicator(P<0.05).The levels of serum CysC,mAlb,urine β2-MG and APACHEⅡ score in survival cases were significantly lower than those in death cases(P<0.01).Conclusions:The serum CysC,mAlb and urine β2-MG are closely related to the severity and prognosis of AKI patients,which can be used as an important indicator in evaluating the severity and prognosis of AKI patients.
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Key words:
- acute kidney injury /
- serum Cystatin C /
- microdose albumin /
- β2-microglobulin /
- prognosis
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