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目的:探讨血清半胱氨酸蛋白酶抑制剂C(CysC)及尿性粒细胞明胶酶相关脂质运载蛋白(NGAL)在百草枯中毒患者急性早期肾损伤(AKI)中的诊断价值。方法:选择2011年3月至2015年3月我院收治的300例百草枯中毒患者为病例组,另选取来我院150例健康体检者为对照组,病例组根据是否发生AKI分为AKI组与非AKI组,各150例,采用酶联免疫吸附法检测NGAL、肌氨酸氧化酶法检测血清肌酐(Scr)水平、免疫透射比浊法检测CysC水平,观察所有对象入院后15 min、2 h、4 h、8 h、12 h、24 h、48 h、3 d、5 d、7 d CysC、NGAL以及Scr表达水平的变化。结果:AKI组和非AKI组患者入院后8 h、12 h、24 h、48 h、3 d、5 d、7 d的Scr水平均高于对照组,差异具有统计学意义(P<0.05);AKI组患者入院后12 h、24 h、48 h、3 d、5 d、7 d Scr水平明显高于非AKI组,差异具有统计学意义(P<0.05);AKI组入院后2 h、4 h、8 h、12 h、24 h、48 h、3 d、5 d、7 d,非AKI组入院后8 h、12 h、24 h、48 h、3 d、5 d、7 d的NGAL水平明显高于对照组,差异均有统计学意义(P<0.05);AKI组患者NGAL水平在入院后48 h升至峰值,而后开始缓慢下降,且AKI组入院后4 h的NGAL水平便开始明显高于非AKI组(P<0.05);AKI组基本在入院后8 h、非AKI组在入院后12 h的CysC水平便明显高于对照组(P<0.05),AKI组基本在入院后3d升至峰值,而后开始缓慢下降,且AKI组在入院后12 h的CysC水平便开始明显高于非AKI组,差异具有统计学意义(P<0.05)。结论:血清CysC及尿NGAL水平在百草枯中毒后短时间内会出现异常升高,对早期诊断AKI具有积极意义。
Objective: To investigate the diagnostic value of serum cystatin C (CysC) and urinary granulocytic gelatinase-associated lipocalin (NGAL) in patients with acute early renal injury (AKI) after paraquat poisoning. Methods: From March 2011 to March 2015, 300 cases of paraquat poisoning admitted to our hospital were selected as case group. Another 150 healthy people in our hospital were selected as control group. AKI patients were divided into AKI group And non-AKI group (n = 150). The levels of serum creatinine (Scr) were detected by enzyme-linked immunosorbent assay (ELISA) and CysC by immunoturbidimetry. h, 4 h, 8 h, 12 h, 24 h, 48 h, 3 d, 5 d, 7 d. Results: The levels of Scr in AKI group and non-AKI group were significantly higher than those in control group at 8 h, 12 h, 24 h, 48 h, 3 d, 5 d and 7 d after admission (P <0.05) ; AKI group Scr levels at 12 h, 24 h, 48 h, 3 d, 5 d and 7 d after admission were significantly higher than those in non-AKI group (P <0.05); AKI group 2 h after admission, 4 h, 8 h, 12 h, 24 h, 48 h, 3 d, 5 d, 7 d (P <0.05). The level of NGAL in AKI group peaked at 48 hours after admission and then began to decline slowly. The level of NGAL in AKI group at 4 hours after admission was significantly higher than that in control group (P <0.05). The level of CysC in AKI group was significantly higher than that in non-AKI group (P <0.05) at 8 h after admission. The level of CysC in non-AKI group at 12 h after admission was significantly higher than that in control group After 3 days, it peaked and then began to decline slowly. The level of CysC in AKI group was significantly higher than that in non-AKI group at 12 hours after admission (P <0.05). Conclusion: Serum CysC and urinary NGAL levels may be abnormally elevated within a short period of time after paraquat poisoning, which is of positive significance for the early diagnosis of AKI.