中国现代医学杂志2016，Vol.26Issue(5)：31-35,5.DOI:10.3969/j.issn.1005-8982.2016.05.007
胱抑素C、肾损伤分子-1、血肌酐在先天性心脏病体外循环术所致急性肾损伤早期预警中的临床价值
Clinical value of CyS C, Kim-1 and SCr in acute kidney injury induced by cardiopulmonary bypass of patients with congenital heart diseases
摘要
Abstract
Objective To investigate the clinical value of cystatin C (CyS C), kidney injury molecule-1 (Kim-1) and serum creatinine (SCr) in early warning of acute kidney injury (AKI) induced by cardiopulmonary bypass (CPB) of congenital heart diseases. Methods A total of 100 patients hospitalized into our hospital from January to December 2014 for congenital heart diseases were chosen as study subjects. Among them 26 patients who had AKI after CPB were into group Ⅰ, and the remaining 74 patients without AKI were into group II. The changes of CyS C, Kim-1, SCr and urinary production (UPD) were compared between the two groups before CPB and at each time point after CPB. Results Before CPB surgery, there was no significant difference in CyS C, Kim-1 or SCr between the two groups ( >0.05). In the group II, the post-operative CyS C, Kim-1 and SCr increased slightly compared with the preoperative values, the differences were not significant ( >0.05). In the group Ⅰ, CyS C at 2 h after CPB significantly increased, Kim-1 at 6 h after CPB significantly increased, both of them reached the maximum at 12 h ( <0.05); SCr began to rise after CPB, reached the peak at 12 h after CPB, after that it increased slowly ( <0.05). At each time point after CPB, CyS C, Kim-1 and SCr of the group Ⅰ were significantly higher than those of the group II ( <0.05); while UPD was lower than that of the group II ( <0.05). The combined detection of KIM-1, Cys C and SCr had the biggest ROC area under the curve, which was 0.8563 and significantly higher than that of UPD and SCr (0.7135). Conclusions The occurrence of AKI is high in patients with congenital heart diseases (26%). CyS C and Kim-1 can significantly increase at the ultra-early time of AKI, but SCr increases quite slowly. Compared to the traditional combined detection of SCr and UPD, the combined detection of KIM-1, Cys C and SCr has a greater clinical value in early warning of acute kidney injury induced by CPB in patients with congenital heart diseases, it is worth promoting.关键词
胱抑素C(CyS C)/肾损伤分子- 1(Kim- 1)/血肌酐(SCr)/先天性心脏病/体外循环术/急性肾损伤/早期预警Key words
cystatin C/kidney injury molecule-1/creatinine/congenital heart disease/cardiopulmonary bypass surgery/acute kidney injury/early warning分类
医药卫生引用本文复制引用
胡秀红,杨洪娟,王会卿,王静,李明明,崔红蕊,任广伟,牛哲莉..胱抑素C、肾损伤分子-1、血肌酐在先天性心脏病体外循环术所致急性肾损伤早期预警中的临床价值[J].中国现代医学杂志,2016,26(5):31-35,5.基金项目
河北省卫生计生委资助项目 （）
