Makinde Ronke A, Alaje Abiodun K, Ajose Abiodun O, Adedeji Tewogbade A, Onakpoya Uvie U
Department of Chemical Pathology, Obafemi Awolowo University Teaching Hospital Complex, Ileife, Nigeria.
Department of Surgery, Cardiothoracic Unit, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria.
Ann Card Anaesth. 2025 Apr 1;28(2):128-135. doi: 10.4103/aca.aca_104_24. Epub 2025 Apr 16.
This was a prospective, longitudinal study, of 40 children who had open heart surgery, on account of congenital heart diseases, at our study center, between April 2020 and June 2022. Plasma samples were assayed for cystatin-C using the enzyme-linked immunosorbent assay method, while quantification of creatinine was done using a Roche automated analyzer (Cobas C311).
Mean plasma concentrations of cystatin-C at 0, 4, 8, 12, 24 and 48 hours were 0.49±0.11 ng/dL, 0.75 ± 0.19 ng/dL, 0.96 ± 0.23 ng/dL, 0.79 ± 0.20 ng/dL, 0.66 ± 0.15 ng/dL, and 0.60 ± 0.14 ng/dL, respectively, versus 48.98 ± 11.6 μmol/L, 59.65 ± 13.06 μmol/L, 63.00 ± 16.53 μmol/L, 64.90 ± 17.65 μmol/L, 68.50 ± 19.99 μmol/L, and 70.78 ± 21.86 μmol/L, respectively, of creatinine. Plasma cystatin-C peaked earlier at 8 hours compared to creatinine, which peaked at 48 hours. The ROC curve showed that cystatin-C had an AUC of 0.983.
This study showed that cystatin-C has a better sensitivity and specificity than creatinine in predicting CSA-AKI in children who had open heart surgery for congenital heart diseases.
这是一项前瞻性纵向研究，研究对象为2020年4月至2022年6月期间在我们研究中心因先天性心脏病接受心脏直视手术的40名儿童。采用酶联免疫吸附测定法检测血浆中的胱抑素C，同时使用罗氏自动分析仪（Cobas C311）对肌酐进行定量分析。
胱抑素C在0、4、8、12、24和48小时的平均血浆浓度分别为0.49±0.11 ng/dL、0.75±0.19 ng/dL、0.96±0.23 ng/dL、0.79±0.20 ng/dL、0.66±0.15 ng/dL和0.60±0.14 ng/dL，而肌酐的平均血浆浓度分别为48.98±11.6 μmol/L、59.65±13.06 μmol/L、63.00±16.53 μmol/L、64.90±17.65 μmol/L、68.50±19.99 μmol/L和70.78±21.86 μmol/L。与在48小时达到峰值的肌酐相比，血浆胱抑素C在8小时更早达到峰值。ROC曲线显示胱抑素C的AUC为0.983。
本研究表明，在预测因先天性心脏病接受心脏直视手术的儿童发生CSA-AKI方面，胱抑素C比肌酐具有更好的敏感性和特异性。
