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目的:检测复苏后患者早期血清胱抑素C(Cys-C)的变化,研究Cys-C早期升高对该类患者预后的影响。方法:前瞻性研究2014-01-01-2016-06-01南京医科大学第一附属医院和南京军区南京总医院收治的心搏骤停(CA)后达到自主循环恢复(ROSC)患者,按患者入院24h内Cys-C升高是否≥3%,分为Cys-C升高组和Cys-C未升高组。比较2组患者急性肾损伤(AKI)发生率、ICU住院时间、肾脏替代治疗率和60d内病死率。结果:共49例复苏后患者入组,Cys-C升高组和Cys-C未升高组分别为32例和17例。2组患者ICU住院时间、肾替代治疗比较差异无统计学意义,而Cys-C升高组患者AKI发生率、60d病死率明显高于Cys-C未升高组(P<0.05)。结论:对于复苏后达到ROSC的患者,早期血清Cys-C升高可能提示更高的AKI发生率,以及不良预后。
Objective: To detect the changes of early serum cystatin C (Cys-C) levels after resuscitation and to investigate the effect of early Cys-C elevation on the prognosis of these patients. METHODS: Prospective study 2014-01-01-2016-06-01 Patients with spontaneous circulation recovery (ROSC) after cardiac arrest (CA) were admitted to First Affiliated Hospital of Nanjing Medical University and Nanjing General Hospital of Nanjing Military Region. Cys-C within 24h of admission increased ≥ 3%, divided into Cys-C elevated group and Cys-C non-elevated group. The incidences of acute kidney injury (AKI), ICU stay, renal replacement therapy and mortality within 60 days were compared between the two groups. Results: A total of 49 patients after resuscitation into the group, Cys-C elevated group and Cys-C non-elevated group were 32 cases and 17 cases. There was no significant difference between the two groups in the length of ICU stay and the renal replacement therapy. However, the incidence of AKI in Cys-C elevated group was significantly higher than that in Cys-C non-elevated group (P <0.05). CONCLUSIONS: Elevated Cys-C in early serum may suggest a higher incidence of AKI and poor prognosis in patients who achieve ROSC after resuscitation.