血肌酐联合胱抑素C根据KDIGO标准诊断急性肾损伤

发布时间：2018-09-19 19:47

【摘要】：目的研究血肌酐联合胱抑素C诊断急性肾损伤(AKI)的临床价值。方法回顾性分析7 627例住院患者临床资料。根据全球肾脏病预后组织(KDIGO)标准分别用肌酐或胱抑素C判断有无AKI。结果最高血胱抑素C水平和肌酐值显著相关(Spearman相关系数0.699,P0.001)。最高胱抑素C水平预测院内死亡的受试者工作特征曲线下面积0.761(95%可信区间0.693~0.828)。符合血肌酐和胱抑素C标准的AKI分别有1 004例(13.2%)和173例(2.3%)。血肌酐联合胱抑素C判断AKI,1 119例(14.7%)发生AKI。在多变量Logistic回归模型中,和血肌酐(-)胱抑素C(-)组比较,血肌酐(-)胱抑素(+)显著增加死亡的风险(OR值15.524,95%可信区间5.110~47.166)。结论联合胱抑素C能提高血肌酐诊断AKI的敏感性,有助于识别高危住院人群。
[Abstract]:Objective to study the clinical value of serum creatinine combined with cystatin C in the diagnosis of acute renal injury (AKI). Methods the clinical data of 7 627 inpatients were retrospectively analyzed. Using creatinine or cystatin C to determine the presence of AKI. according to the (KDIGO) criteria for prognosis tissue of global kidney disease Results the highest level of serum cystatin C was significantly correlated with creatinine (Spearman correlation coefficient 0.699mP0.001). The area under the operating characteristic curve of the highest level of cystatin C to predict the nosocomial death was 0.761 (95% confidence interval 0.693c0.828). There were 1 004 cases (13. 2%) and 173 cases (2. 3%) of AKI in accordance with serum creatinine and cystatin C standard, respectively. Serum creatinine combined with cystatin C in the diagnosis of AKI. in 119 cases of AKI,1 (14.7%) In multivariate Logistic regression model, compared with the serum creatinine (-) cystatin C (-) group, serum creatinine (-) cystatin significantly increased the risk of death (OR 15.524 95% CI 5.11010 47.166). Conclusion combined with cystatin C can improve the sensitivity of serum creatinine in the diagnosis of AKI and is helpful to identify high risk inpatients.
【作者单位】：广东省五华县人民医院内二科;广东省人民医院肾内科广东省医学科学院;广州医科大学公共卫生学院预防医学系;
【基金】：广东省科技计划协同创新与平台环境建设项目(编号:2017A070709008) 广州市科技计划项目产学研协同创新重大专项(编号:201604020037) 广东省卫生计生适宜技术推广项目资助项目(编号:2016200)
【分类号】：R692

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