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目的了解尿肾损伤分子-1(KIM-1)和血清胱抑素C(CysC)联合检测对冠状动脉介入后对比剂致急性肾损伤(CI-AKI)的早期诊断意义。方法 351例行冠状动脉介入患者,检测术前及术后12、24、48 h血清肌酐(Scr)和血清胱抑素C(CysC)、尿KIM-1水平,比较43例CI-AKI和43例对照者Scr、CysC、KIM-1水平。结果对照组术后Scr、CysC及KIM-1水平与术前比较,差异无统计学意义(P>0.05)。与术前及同时点对照组比较,CI-AKI组术后各时点KIM-1水平、术后24h和48 h Scr水平、以及术后24 h Cys C水平均明显升高(P<0.01或0.05)。CI-AKI组术后24 h Scr与KIM-1及CysC水平呈正相关(r值分别为0.718与0.629,均P<0.01)。结论联合检测尿KIM-1和血清CysC水平可能有助于早期诊断CI-AKI。
Objective To investigate the early diagnosis of acute renal injury induced by contrast medium (CI-AKI) after coronary intervention (KIM-1) and serum cystatin C (CysC). Methods A total of 351 patients with coronary artery involvement were enrolled in this study. Serum creatinine (Scr), serum cystatin C (CysC) and urinary KIM-1 levels were measured before and 12,24,48 h postoperatively. Forty-three CI-AKI and 43 Example control Scr, CysC, KIM-1 levels. Results There was no significant difference in the levels of Scr, CysC and KIM-1 in the control group after operation (P> 0.05). The level of KIM-1, the level of Scr at 24h and 48h after operation and the level of Cys C at 24 hours after operation in CI-AKI group were significantly higher than those in control group before and at the same time (P <0.01 or 0.05). There was a positive correlation between Scr and KIM-1 and CysC levels at 24 h after CI-AKI (r = 0.718 and 0.629, respectively, P <0.01). Conclusions Combined detection of urine KIM-1 and serum CysC levels may be helpful in the early diagnosis of CI-AKI.