摘要
目的:分析胱抑素C(Cys-C)、视黄醇结合蛋白(RBP)、β_2微球蛋白(β_2-MG)、血肌酐(Scr)及尿素氮(BUN)等血清学标志物诊断不同程度梗阻性肾积水的敏感性及其判断肾功能预后的准确性。方法:收集近5年我院就诊单侧梗阻性肾积水并经手术完全解除梗阻301例患者的临床资料,分组分析血清标志物与核素肾动态显像测得肾小球滤过率(GFR)相关性。并综合相关危险因素指标对术后肾功能恢复水平进行单因素分析,对有统计意义指标行Logistic多因素回归分析。结果:轻、中度肾积水β_2-MG与GFR相关性最强(r=-0.427、-0.493,P<0.01),对于重度肾积水Cys-C更具相关性(r=-0.716,P<0.01)。最终多因素分析示:术前CysC、梗阻时限、皮肾质厚度、性别是肾功能恢复能力的影响因素(P<0.05)。结论:β2-MG对轻中度肾积水,Cys-C对重度肾积水具有最佳诊断敏感性,术前Cys-C值高、肾皮质薄、梗阻时间长及女性患者术后肾功能不易恢复。
Objective：To investigate the statistics of biomarkers：Cystatin C（Cys-C）,Retinol-Binding Protein（RBP）,β2-MG,Creatinine（Scr）,Blood urea nitrogen（BUN）,in the diagnosis and prognosis of hydronephrosis.Method：We collected 301 cases of unilateral hydronephrosis whose obstruction were completely relieved in our hospital during the past 5 years,and analysed the correlation between biomarkers and Glomerular filtration rate（GFR）measured by radionuclide examination by statistical grouping method.To realize the effects on postoperative kidney function,we analysed them together with other related factors by univariate analysis and logistic multivariate regression.Result：For mild to moderate hydronephrosis,β2-MG showed the strongest correlation with GFR（r=-0.427/-0.493,P〈0.01）,while Cys-C was the most significant marker for sever hydronephrosis（r=-0.716,P〈0.01）.Logistic regression analysis indicated that the preoperative Cys-C,renal cortical thickness,duration of obstruction and gender were the factors influencing postoperative kidney function（P〈0.05）.Conclusion：β2-MG is the best marker to diagnose mild to moderate hydronephrosis,and Cys-C shows strongest diagnosis sensitivity to severe ones.Patients with higher preoperative Cys-C value,thinner renal cortical,longer obstructive period,and especially female patients are more likely to have difficulties in kidney function recovery.
作者
刘健男
刘亚东
杨可来尔
安瑞华
LIU J iannan;LIU Yadong;YANG Kelaier;AN Ruihua(Department of Urology, First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China)
出处
《临床泌尿外科杂志》
2018年第5期393-397,共5页
Journal of Clinical Urology
基金
国家自然科学基金项目(编号81370803)
关键词
肾积水
血清标志物
肾功能
敏感性
危险因素
hydronephrosis
biomarker
kidney function
sensitivity
risk factor
