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目的分析对儿童急性肾损伤患儿的疾病评估中加强血清胱抑素C(Cystatin C,Cys-C)测评的临床应用价值。方法选取2013年2月—2014年10月本院收治的98例急性肾损伤患儿作为观察组,并根据急性肾损伤分期情况分为Ⅰ期32例,Ⅱ期33例,Ⅲ期33例;并以同期收治的128例非急性肾损伤患儿作为对照组。比较入选对象的Cys-C、BUN和Scr水平。计量资料采用t检验和方差分析,两两比较采用LSD-t检验,采用Pearson相关进行相关性分析,P<0.05为差异有统计学意义。结果观察组患儿的Cys-C、BUN和Scr水平分别为(2.70±1.05)mmol/L、(18.94±11.02)μmol/L、(295.70±12.69)mg/L,均明显高于对照组的(0.87±0.40)mmol/L、(6.89±2.80)μmol/L、(89.60±26.10)mg/L,差异均有统计学意义(均P<0.05)。急性肾损伤I期患儿BUN、Scr、Cys-C水平分别为(13.79±7.90)mmol/L、(183.22±11.70)μmol/L、(2.33±1.02)mg/L,Ⅱ期患儿分别为(17.88±7.77)mmol/L、(309.12±43.69)μmol/L、(2.66±0.97)mg/L,Ⅲ期患儿分别为(28.11±18.19)mmol/L、(463.57±69.70)μmol/L、(3.30±1.10)mg/L;观察组Ⅰ期、Ⅱ期、Ⅲ期患儿的BUN、Scr、Cys-C水平与对照组比较差异均有统计学意义(均P<0.05)。不同分期患儿BUN和Scr水平比较差异均有统计学意义(均P<0.05)。观察组患儿BUN、Scr与Cys-C水平呈正相关关系(r=0.4421、0.5881),GFR与Cys-C水平呈负相关关系(r=-0.8032)。结论Cys-C可作为儿童急性肾损伤的内源性标志物,对其临床评估和诊断具有重要的参考价值。
Objective To analyze the clinical value of enhancing serum cystatin C (Cys-C) in the evaluation of children with acute kidney injury. Methods A total of 98 acute kidney injury patients admitted to our hospital from February 2013 to October 2014 were selected as the observation group. According to the stages of acute kidney injury, 32 cases were stage Ⅰ, 33 cases were stage Ⅱ and 33 cases were stage Ⅲ. 128 children with non-acute renal injury were enrolled in the same period as the control group. The Cys-C, BUN and Scr levels of the selected subjects were compared. Measurement data using t test and analysis of variance, two by two comparison using LSD-t test, using Pearson correlation correlation analysis, P <0.05 for the difference was statistically significant. Results The levels of Cys-C, BUN and Scr in the observation group were (2.70 ± 1.05) mmol / L and (18.94 ± 11.02) μmol / L and (295.70 ± 12.69) mg / L, (0.87 ± 0.40) mmol / L, (6.89 ± 2.80) μmol / L and (89.60 ± 26.10) mg / L, respectively, with statistical significance (all P <0.05). The levels of BUN, Scr and Cys-C in stage I children with acute kidney injury were (13.79 ± 7.90) mmol / L, (183.22 ± 11.70) μmol / L and (2.33 ± 1.02) mg / L respectively (28.11 ± 18.19) mmol / L, (463.57 ± 69.70) μmol / L, P <0.01) in the third stage of treatment (17.88 ± 7.77 mmol / L, 309.12 ± 43.69 μmol / L and 2.66 ± 0.97 mg / , (3.30 ± 1.10) mg / L, respectively. The levels of BUN, Scr and Cys-C in stage I, II and III of the observation group were significantly different from those in the control group (all P <0.05). The levels of BUN and Scr in children with different stages were significantly different (all P <0.05). There was a positive correlation between BUN, Scr and Cys-C levels in the observation group (r = 0.4421, 0.5881) and a negative correlation between GFR and Cys-C levels (r = -0.8032). Conclusion Cys-C can be used as an endogenous marker of acute kidney injury in children, which has important reference value for clinical evaluation and diagnosis.