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目的探讨血清半胱氨酸蛋白酶抑制剂C(Cystatin C,Cyst C)评估急性有机磷中毒(acute organophosphoruspesticide poisoning,AOPP)患者肾功能损害的临床价值。方法选取我院确诊的AOPP 102例作为AOPP组,于入院第1天、第3天分别测定血清尿素(BUN)、肌酐(Cr)及Cyst C;另选择同期健康体检者120例作为健康对照组,在门诊抽取静脉血检测上述指标。结果入院后第1天及第3天AOPP组BUN和Cr比较差异均无统计学意义(P>0.05),而血清Cyst C比较差异有统计学意义(P<0.05)。入院后第1天和第3天AOPP组血清BUN、Cr与健康对照组比较差异均无统计学意义(P>0.05),而Cyst C与健康对照组比较差异有统计学意义(P<0.05)。AOPP组入院后第1天血清Cyst C阳性率为49.0%(50/102),BUN与Cr联合检测阳性率为18.6%(19/102);第3天血清Cyst C阳性率为98.0%(100/102),BUN与Cr联合检测阳性率为19.6%(20/102)。结论血清Cyst C可早期反映AOPP患者肾功能损害情况,对AOPP肾功能不全的诊断及预后改善具有重要临床意义。
Objective To investigate the clinical value of serum cystatin C (Cyst C) in assessing renal dysfunction in patients with acute organophosphorus pesticide poisoning (AOPP). Methods 102 AOPP diagnosed in our hospital were selected as the AOPP group. Serum urea (BUN), creatinine (Cr) and Cyst C were measured on the first day and the third day after admission. Another 120 healthy subjects were selected as the healthy control group , Venous blood drawn in the clinic to detect the above indicators. Results There was no significant difference in BUN and Cr between AOPP group and control group on day 1 and 3 (P> 0.05), while serum Cyst C was significantly different (P <0.05). On the 1st and 3rd day after admission, the serum levels of BUN and Cr in the AOPP group were not significantly different from those in the healthy control group (P> 0.05), but there was a significant difference between the Cyst C and healthy controls (P <0.05) . The positive rate of Cyst C in the AOPP group was 49.0% (50/102) on the first day after admission, the positive rate of BUN and Cr was 18.6% (19/102), and the positive rate of Cyst C in the third day was 98.0% (100 / 102). The positive rate of BUN and Cr was 19.6% (20/102). Conclusions Serum Cyst C can early reflect the renal dysfunction in AOPP patients and has important clinical significance for the diagnosis and prognosis of AOPP renal insufficiency.