Peng Yu, Hou Xiao-Lin, Wei Wu-Ran, Shi Xiao-Qing, Xu Peng, Luo Qiu-Hong, Li Li
Department of Editorial, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China.
Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2016 Jul;47(4):556-559.
To investigate the diagnostic value of cystain C (SCys-C) in contrast associated acute kidney injury (AKI) after transcatheter closure for children with congenital heart disease.
There were 128 children with congenital heart disease (interventricular septal defect or patent ductus arteriosus) underwent transcatheter closure in West China Second University Hospital during 2013. Blood urea nitrogen (BUN), serum creatinine (SCr) and SCys-C were examined before surgery and at 24 and 48 h after surgery. The incidence of AKI was calculated. The children were divided into two groups according to glomerular filtration rate: AKI group (renal function stage 1, renal function stage 2 subgroups) and non-AKI group. Differences in renal function indexes and SCys-C were compared between AKI group ( =16) and non-AKI group ( =112), renal function stage 1 and stage 2 subgroups. ROC curve analysis was used to calculate the cut-off value of SCys-C in the diagnosis of AKI .
The levels of SCr and SCys-C in AKI group were significantly higher than those in non-AKI group ( <0.05). However, there was no significant difference in BUN between the two groups ( >0.05). Only SCys-C had a significant difference between renal function stage 1 and stage 2 subgroups ( <0.05). The cut-off value of 24 h SCys-C in the diagnosis of AKI was 1.055 mg/L according to area under curve (). indicated that AKI could be diagnosed earlier with SCys-C than SCr ( <0.05).
The contrast agent could increase the risk of child AKI after transcatheter closure for congenital disease children.SCys-C is an important index for this risk with its cut-off value of 1.055 mg/L at 24 h post-surgery.
探讨胱抑素C(SCys-C)对先天性心脏病患儿经导管封堵术后对比剂相关性急性肾损伤(AKI)的诊断价值。
2013年在四川大学华西第二医院对128例先天性心脏病(室间隔缺损或动脉导管未闭)患儿进行经导管封堵术。术前及术后24小时和48小时检测血尿素氮(BUN)、血清肌酐(SCr)和SCys-C。计算AKI的发生率。根据肾小球滤过率将患儿分为两组:AKI组(肾功能1期、肾功能2期亚组)和非AKI组。比较AKI组(n = 16)和非AKI组(n = 112)、肾功能1期和2期亚组之间肾功能指标和SCys-C的差异。采用ROC曲线分析计算SCys-C诊断AKI的截断值。
AKI组SCr和SCys-C水平显著高于非AKI组(P < 0.05)。然而,两组间BUN无显著差异(P > 0.05)。仅SCys-C在肾功能1期和2期亚组之间有显著差异(P < 0.05)。根据曲线下面积(AUC),24小时SCys-C诊断AKI的截断值为1.055 mg/L。结果表明,与SCr相比,SCys-C能更早诊断AKI(P < 0.05)。
对比剂可增加先天性疾病患儿经导管封堵术后发生AKI的风险。SCys-C是该风险的重要指标,术后24小时截断值为1.055 mg/L。