摘要
目的探讨胱抑素C检测对老年冠心病患者肾功能评价的应用价值，用其观察患者围手术期肾功能的变化情况，指导临床治疗。方法2010年7月至2012年1月在我科行心脏不停跳冠状动脉搭桥术患者，术前按照KDOQICKD筛选出CKD1期（GFR〉90ml·min^-1·1.73m^-2）和CKD2期（60ml·min^-1·1.73m^-2≤GFR〈89ml^-1·1.73m^-2）患者16例，并于手术前、后不同时间点测量血清胱抑素c、肌酐和B：一微球蛋白浓度，观察分析其变化规律。结果胱抑素c、肌酐、β2-微球蛋白与GFR的相关系数分别为0．732,0．630和0．608。冠心病患者术后第1天胱抑素C浓度为（O．882±0．226）mg／L，与术前（1．268±0．154）mg／L相比明显下降（P〈0．05），第2天后呈逐步升高趋势并于第7天达到高峰，胱抑素C浓度为（1．411±0．208）mg／L，与术前相比明显升高（P〈0．05）。结论胱抑素C是检测冠心病患者围手术期肾功能变化情况的良好参考指标。应用胱抑素C观察发现患者不停跳心脏冠状动脉搭桥术后围手术期肾功能仍有损伤。
Objective To understand the value of cystatin C testing for renal function in elderly patients with coronary artery disease and use it to observe the changes in the perioperative renal function to guide clinical treatment. Methods Patients with Beating-heart coronary artery bypass grafting in our department from July 2010 to January 2012 were enrolled. According to KDOQI CKD screening before operation： CKD I（GFR〉90 ml·min^-1·1.73m^-2） and CKD2 （60 ml·min^-1·1.73m^-2〈GFR〈89 ml·min^-1·1.73m^-2） in 16 cases. The levels of cystatin C, creatinine, and beta 2 microglobulin concentrations in different time points were observed and the changes were analyzed. Results The correlation coefficient between Cystatin C, ereatinine, beta 2 microglobulin and GFR were0.732, 0.630, 0.608 respectively. Cystatin C concentration in patients with coronary heart disease in the first day was（0.882±0.220）mg/L, compared with preoperative（1.268±0.154）mg/L it decreased significantly（P〈0.05）. The next day was gradually increasing trend and reached its peak in the seventh day, the cystatin C concentration was （1.41±0.208）rag/L, significantly higher compared with the preoperative（P〈0.05）. Conclusion Serum cystatin C of perioperation period is a good reference index of renal function changes in patients with coronary artery disease, and of the changes of cystatin C pefioperative indicates reduction of renal function in patients with beating-heart coronary artery bypass grafting.
出处
《中国心血管病研究》
CAS
2012年第5期344-346,共3页
Chinese Journal of Cardiovascular Research
