摘要
Abstract
Objective To assess the clinic value of serum cystatin C( CysC ) in the prediction of acute kidney injury( AKI ) in patients with cardiogenic shock. Methods 90 patients with cardiogenic shock were included in this study and classified into AKI and non-AKI groups. Serum creatinine( Scr )and blood urea nitrogen( BUN )were detected by enzymic method. Serum CysC was detected by particle-enhanced turbidimetric immunoassay and glomerular filtration rate( eGFR )was estimated by Cockcroft-Gault equation. The diagnostic accuracy was evaluated by the receiver operator characteristic curve( ROC curve ). Results Compared with non-AKI group, serum CysC, BUN and Scr levels were significantly higher,but eGFR were remarkably lower in AKI group( P ＜ 0.05 ). With the increased severity of AKI,serum CysC,BUN and Scr levels increased, but eGFR decreased( P ＜ 0.05 ). According to linear correlation analysis,serum CysC and BUN were positively correlated with Scr, but had negative correlations with eGFR. When AKI was diagnosed according to eGFR≤60 ml · min-1 · 1.73 m2, the diagnostic accuracy of serum CysC, BUN and Scr was evaluated by area under the curve( AUC )of the ROC curve. The AUCs of the three markers were:AUC( CysC )0. 967 ( 95％ C1:0.907 - 0.986,P ＜ 0.01 ), AUC( Scr ) 0.905( 95％ C1:0.887 - 0.947,P ＜ 0.01 ), AUC( BUN )0. 861( 95％ CI: 0.785 -0.901 ,P ＜0.01 );and the AUC difference between them had statistical significance( P ＜ 0.05 ). Conclusion Serum cystatin C level is positively correlated with the increased severity of AK[. Compared with Scr and BUN,senlm cystatin C could more sensitively and accurately reflecting the decline of renal function in patients with cardiogenic shock, and it is a good diagnostic marker for early kidney damage.关键词
心源性休克/急性肾损伤/胱抑素-C/肌酐/肾小球滤过率Key words
Cardiogenic Shock/ Acute kidney injury/ Cystatin C/ Creatinine/ Glomerular filtration rate分类
医药卫生
