摘要
目的评价尿液中胱抑素C(Cys C)及肾损伤分子-1(KIM-1)联合检测在冠状动脉旁路移植术后急性肾损伤(AKI)中的临床意义。方法回顾性分析2011年5月至2013年10月在非体外循环下行冠状动脉旁路移植术的182例患者临床资料。其中23例患者发生急性肾损伤(AKI组),159例患者未发生急性肾损伤(非AKI组)。分别检测两组术前,麻醉诱导后,术后12 h、24 h、48 h、72 h的血清肌酐(Scr)、血清尿素氮(BUN)水平的变化以及尿液中胱抑素C(Cys C)及肾损伤分子-1(KIM-1)的含量,分析各项指标含量的变化与急性肾损伤的关系。结果在冠状动脉旁路移植术前两组各项指标均无统计学差异(P>0.05)。冠状动脉旁路移植术后,AKI组Scr、BUN含量在术后72 h时均较术前各时间段增高,且与非AKI组间比较有统计学差异(P<0.05);AKI组患者尿液Cys C含量于术后12 h增高,24 h达高峰值,48 h后逐渐下降,与非AKI组比较有统计学差异(P<0.05);AKI组尿液中KIM-1含量于术后24 h增高,48 h达高峰值,明显高于同期非AKI组,组间比较有统计学差异(P<0.05)。结论冠状动脉旁路移植术后早期联合检测尿液Cys C、KIM-1含量的变化,对诊断急性肾损伤有指导意义。
Objective To analyze the clinical significance of cystatin C（ Cys C） and kidney injury molecule-1（ KIM-1） for acute kidney injury after coronary artery bypass surgery. Methods We retrospectively analyzed the clinical data of 182 patients who underwent off-pump coronary artery bypass surgery. The patients were divided into acute kidney injury（ AKI） group（ n = 23）,and non-AKI（ NAKI） group（ n =159）. Serum Scr,BUN and urine Cys C and KIM-1 were detected preoperatively and at 12 h,24 h,48 h,and 72 h postoperatively. The relationship between the changes of these parameters and acute kidney injury was analyzed. Results There was no significant difference in above mentioned parameters between AKI and NAKI groups before surgery（ P〉0. 05）. At 72 h after surgery,serum levels of Scr and BUN in AKI group were relatively higher than those before the surgery and significantly different from those in NAKI group（ P〈0. 05）. In AKI group,urine Cys C level increased at 12 h,reached the peak at 24 h and decreased at 48 h after surgery; and significant differences were found between AKI and NAKI group（ P〈0. 05）. Meanwhile urine KIM-1 level increased at 24 h,reached the peak at 48 h after surgery in AKI group and their levels were obviously higher than those in NAKI group（ P〈0. 05）. Conclusion The joint detection of Cys C and KIM-1 early after the coronary artery bypass surgery is important for the diagnosis of AKI.
出处
《临床和实验医学杂志》
2014年第17期1441-1444,共4页
Journal of Clinical and Experimental Medicine
