清蛋白、胱抑素C及胆红素联合检测在急性脑梗死合并急性肾损伤中的预测价值(1)

http://www.100md.com 2020年3月15日 《中国当代医药》 20208

     [摘要]目的 探討清蛋白(ALB)、胱抑素C(CysC)及胆红素(TB)联合检测在急性脑梗死合并急性肾损伤(AKI)中的预测价值。方法 选取2018年1～12月我院收治的30例急性脑梗死合并AKI患者作为急性脑梗死+AKI组，30例急性脑梗死无AKI作为急性脑梗死组，另选取30例同期健康体检者作为对照组。比较各组受试者的血清生化指标及美国国立卫生研究院卒中量表(NIHSS)评分，有差异的指标进行Logistic回归分析，并采用受试者工作特征(ROC)曲线评估指标的预测价值。结果 急性脑梗死+AKI组的ALB、CysC、超敏C-反应蛋白(hs-CRP)水平均高于急性脑梗死组和对照组，TB水平低于急性脑梗死组和对照组，急性脑梗死+AKI组的NIHSS评分高于急性脑梗死组，差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示，ALB、CysC及TB是急性脑梗死合并AKI的危险因素(P<0.05)。ROC曲线分析显示，ALB、CysC及TB三项联合检测的曲线下面积(AUC)大于ALB、CysC、TB单独检测，差异有统计学意义(P<0.05)。结论 ALB、CysC及TB对急性脑梗死合并AKI具有较高预测价值，联合检测可提高预测灵敏度和特异度。

    [关键词]清蛋白;胱抑素C;胆红素;急性脑梗死;肾损伤

    [中图分类号] R743.33 [文献标识码] A [文章编号] 1674-4721(2020)3(b)-0048-04

    Predictive value of combined detection of albumin， cystatin C and bilirubin in acute cerebral infarction complicated with acute kidney injury

    CHI Rui-feng LIN Bing-wei LIN Xi-chun

    Department of Internal Medicine， the Second People′s Hospital of Jiedong District in Jieyang City， Guangdong Province， Jieyang 515500， China

    [Abstract] Objective To investigate the predictive value of combined detection of albumin (ALB)， cystatin C (CysC) and bilirubin (TB) in acute cerebral infarction complicated with acute kidney injury (AKI). Methods A total of 30 patients with acute cerebral infarction and AKI admitted to our hospital from January to December 2018 were selected as the acute cerebral infarction+AKI group， 30 patients with acute cerebral infarction without AKI were selected as the acute cerebral infarction group， and another 30 healthy subjects with healthy physical examinations were selected as the controls group. The serum biochemical indicators and the national institutes of health stroke scale (NIHSS) scores were compared among each group of subjects. Logistic regression analysis was performed on the indicators with differences， and the receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the indicators. Results The levels of ALB， CysC， and high-sensitivity C-reactive protein (hs-CRP) in the acute cerebral infarction+AKI group were higher than those in the acute cerebral infarction group and control group， the TB level was lower than that in the acute cerebral infarction group and control group， the NIHSS score in the acute cerebral infarction+AKI group was higher than that in the acute cerebral infarction group， and the differences were statistically significant (P<0.05). Multivariate Logistic regression analysis showed that ALB， CysC， and TB were risk factors for acute cerebral infarction with AKI (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of the combined detection of ALB， CysC， and TB was larger than that of ALB， CysC， and TB detection alone， and the differences were statistically significant (P<0.05). Conclusion ALB， CysC and TB have high predictive value for acute cerebral infarction complicated with AKI， and combined detection can improve prediction sensitivity and specificity.(池锐锋 林冰薇 林喜春)

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