il审审18联合cys c评价危重病人早期急性肾损伤的临床研究-clinical study of il trial 18 combined with cys c in evaluating early acute kidney injury in critically ill patients.docx

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il审审18联合cys c评价危重病人早期急性肾损伤的临床研究-clinical study of il trial 18 combined with cys c in evaluating early acute kidney injury in critically ill patients.docx

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il审审18联合cys c评价危重病人早期急性肾损伤的临床研究-clinical study of il trial 18 combined with cys c in evaluating early acute kidney injury in critically ill patients

AbstractObject: To explore the role of serum cystatin C(sCys C) combined with urinary interleukin-18(uIL-18) changes on clinical evaluation function for critical ill patients with early acute kidney injury(AKI) in ICU. Method: Critical ill patients who had admission to the intensive care unit from October 2009 to October 2010were selected by strict included and excluded criteria. Blood and urine samples were collected every day for a week after their admission. Urine specimens were analyzed by enzyme-linked immunosorbent assay for uIL-18. Concentration of serum cystatin C were analyzed by particle reinforced nephelometric immunoassay. According to the measurement results, patients were divided into four groups: group A (uIL-18100pg/ml, sCys C for any values), group B(sCys C1.5mg/L, uIL-18 for any values), group C(uIL-18100 pg/ml and sCys C1.5mg/L), group D(uIL-18100 pg/ml and sCys C1.5mg/L).Then the AKI incidence was observed and calculated among groups. The role of sCys C and uIL-18 on diagnosing acute kidney injury was evaluated by ROC curve statistics.Finally Observed the clinical outcome of critical ill patients among groups, and then calculated thier mortality.Result: In group A, B, C, and D, the AKI incidences were 82.60%, 92.59%, 95%, 3.33% respectively. The incidences of group A, B and C were higher than group D (P0.0071). With the variables of sCys C, uIL-18 and sCys CuIL-18 ,the area under the curve were 0.602(P0.05), 0.793(P0.050), 0.850(P0.05) respectively. The mortality of group A, B, C and D were 45%, 44%, 40%, 27% there was no statistic significance among group A , B, C,but there was significant difference each when group A,group B and group C respectively compared with group D(P0.0071).Conclusion: The measurement of sCys C,uIL-18 and sCys C combined with uIL-18 is usefull for the diagnosis of AKI in the early period.The measurement of sCys C and uIL-18 being combined is better than that of sCys C or uIL-18 alone in diagnosing of AKI in cr