[1]罗 武a,马琼卉a,刘 兴a,等.新型冠状病毒肺炎并发急性肾损伤患者血清胱抑素C，尿素氮和肌酐水平变化及临床价值研究[J].现代检验医学杂志,2023,38(02):194-199.[doi:10.3969/j.issn.1671-7414.2023.02.037 ]
　LUO Wua,MA Qiong-huia,LIU Xinga,et al.Variation of Level，Risk Factors and Clinical Value Research of Serum Cystatin C, Blood Urea Nitrogen and Creatinine in Patients with COVID-19 Complicated with Acute Kidney Injury[J].Journal of Modern Laboratory Medicine,2023,38(02):194-199.[doi:10.3969/j.issn.1671-7414.2023.02.037 ]
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新型冠状病毒肺炎并发急性肾损伤患者血清胱抑素C，尿素氮和肌酐水平变化及临床价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年02期
页码:
194-199
栏目:
新型冠状病毒肺炎检验专题
出版日期:
2023-03-15

文章信息/Info

Title:
Variation of Level，Risk Factors and Clinical Value Research of Serum Cystatin C, Blood Urea Nitrogen and Creatinine in Patients with COVID-19 Complicated with Acute Kidney Injury
文章编号:
1671-7414（2023）02-194-06
作者:
罗 武a; 马琼卉a; 刘 兴a; 李南南b; 李 贞c; 伍 勇a; 陶 婷c
（长沙市第一医院 a.检验科；b.泌尿外科；c.病理科，长沙 410005）
Author(s):
LUO Wua;  MA Qiong-huia;  LIU Xinga;  LI Nan-nanb;  LI Zhenc;  WU Yonga;  TAO Tingc
（a.Department of Clinical Laboratory；b.Department of Urology；c.Department of Pathology, the first Hospital of Changsha, Changsha 410005, China ）
关键词:
胱抑素 C; 尿素氮; 肌酐; 新型冠状病毒肺炎; 急性肾损伤
分类号:
373.19；R446.112
DOI:
10.3969/j.issn.1671-7414.2023.02.037
文献标志码:
A
摘要:
目的 探讨血清胱抑素 C（cystatin C，Cys-C）、尿素氮（blood urea nitrogen ，BUN）和肌酐（creatinine， Cr）在新型冠状病毒肺炎并发急性肾损伤患者的水平变化、危险因素评估及临床应用价值。方法 选取 2020年 1月～3月长沙市第一医院公共卫生救治中心收治的 120例新型冠状病毒（COVID-19）确诊患者，按照《新型冠状病毒肺炎诊疗方案 (试行第七版 )》分为普通型、轻型、重症型及危重型四种，根据改善全球肾脏病预后组织 (Kidney Disease Im-proving Global Outcomes, KDIGO)指南、既往病史和临床症状将患者分为急性肾损伤（acute kidney injury，AKI）组 15例与非急性肾损伤 (non acute kidney injury，NAKI)组 105例，通过收集整理病人的一般资料、入院症状及血清 Cys-C， BUN和 Cr的实验室检查结果，统计分析 COVID-19患者 AKI组与 NAKI组患者间各项指标的水平变化；并采用多因素 Logistic回归分析 COVID-19并发 AKI的危险因素。结果 该研究纳入的 COVID-19患者，AKI组与 NAKI组的性别构成比比较差异无统计学意义 (χ2=1.193，P>0.05)；AKI组与非 AKI组的年龄构成比比较， AKI组平均年龄大于 NAKI组，差异有统计学意义 (t=12.469, P<0.05); COVID-19患者血清 Cys-C，BUN和 Cr水平在普通型和重症型之间比较差异无统计学意义 (t=2.464, P>0.05)；危重组患者血清 Cys-C，BUN和 Cr水平明显高于重症组 (t=9.164，7.342，11.255，均 P＜ 0.05)，危重组患者血清 Cys-C，BUN和 Cr水平明显高于普通组 (t=24.958，15.461，19.224，均 P＜ 0.001)，差异均有统计学意义。AKI组与 NAKI组在入院初期的血清 Cys-C，BUN和 Cr水平差异无统计学意义（t=0.274，0.308，1.253，均 P>0.05）；AKI组患者入院进展期血清 Cys-C，BUN和 Cr水平明显高于 NAKI组（t=22.144，16.325，33.289，均 P <0.001），AKI组患者入院恢复期平均血清 Cys-C，BUN和 Cr水平明显高于 NAKI组（t=10.498，4.326，8.794，均 P <0.05），差异均有统计学意义。 Logistic回归分析结果表明，高龄（OR=3.25，95%CI:1.12～8.09，P<0.001）、有基础疾病如糖尿病（OR=2.15,95%CI:1.02～7.55, P=0.039）、有基础疾病如高血压病（OR=2.27,95%CI:1.24～7.66, P=0.025）、高 C反应蛋白（OR=2.01,95%CI：1.45～2.29, P<0.001）、高 Cr（OR=1.09, 95%CI:0.98～1.28, P=0.08）和高 Cys-C（OR=3.01, 95%CI:1.95～2.48，P<0.001）是 COVID-19并发 AKI的主要危险因素。结论 Cys-C，BUN和 Cr三个指标的联合动态检测在新冠肺炎患者 ,尤其在危重型高龄患者的肾损伤评估和监测中起重要作用，对于判断 COVID-19并发 AKI患者的病情危重、疾病发展及预后评估具有重要的临床应用价值。高龄、有基础疾病（糖尿病、高血压）及 C反应蛋白、肌酐、胱抑素 C水平升高是 COVID-19患者并发 AKI 的主要危险因素。
Abstract:
Objective To discuss variation of level，risk factors and clinical application value of serum cystatin C (Cys-C), blood urea nitrogen (BUN) and creatinine (Cr) in patients with COVID-19 complicated with acute kidney injury. Methods

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备注/Memo

备注/Memo:
收稿日期：2022-09-26 修回日期：2022-12-17

更新日期/Last Update: 2023-03-15