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目的探讨血清胱抑素C、尿微量蛋白(β2-微球蛋白、α1-微球蛋白、转铁蛋白、微量白蛋白)联合检测在万古霉素致早期肾损害中的临床价值。方法 40例耐甲氧西林金黄色葡萄球菌(MRSA)肺部感染患者,应用万古霉素治疗前后联合检测血清胱抑素C、尿微量蛋白的变化。结果 40例MRSA肺部感染患者应用万古霉素治疗后,血清胱抑素C、尿微量蛋白阳性率明显高于血肌酐、尿素氮和尿常规阳性率(P均<0.05)。老年患者万古霉素治疗后血清胱抑素C、尿微量蛋白阳性率明显高于中青年患者(P均<0.05)。结论老年人应用万古霉素较为安全,血清胱抑素C、尿微量蛋白联合检测可早期发现万古霉素所致肾损害。
Objective To investigate the clinical value of combined detection of serum cystatin C, urinary microalbumin (β2-microglobulin, α1-microglobulin, transferrin and microalbumin) in early renal damage caused by vancomycin. Methods Forty patients with methicillin - resistant Staphylococcus aureus (MRSA) pulmonary infection were enrolled in this study. Serum levels of cystatin C and urine microalbumin were detected before and after treatment with vancomycin. Results The positive rates of serum cystatin C and urinary microalbumin in 40 MRSA patients with pulmonary infection were significantly higher than those of serum creatinine, urea nitrogen and urine (all P <0.05) after treatment with vancomycin. Serum levels of cystatin C and urinary microalbumin in elderly patients with vancomycin were significantly higher than those in middle-aged and young patients (all P <0.05). Conclusion The elderly with vancomycin is more safe, serum cystatin C, urine microalbumin combined detection of early detection of vancomycin-induced renal damage.