在不同的患者护理环境中,肌素与囊素C估计的淋巴球过率之间的差异
Li Liu1, Daniel Y Chang1, Kent B Lewandrowski1
1Department of Pathology, Massachusetts General Hospital, United States; Harvard Medical School, Boston, MA, United States.
Clinical biochemistry
|July 19, 2024
概括
基于cystatin C (cysC) 的估计膜过率 (eGFR) 在住院患者和并发症患者中显示与肌素 (eGFRcr) 的差异. 结合的eGFR减少了这些差异,支持更广泛的采用.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床化学 临床化学
- 生物标志物 生物标志物
背景情况:
- 估计的膜过率 (eGFR) 对于评估功能至关重要.
- 基于cystatin C (cysC) 的eGFR (eGFRcys) 越来越多地被推用于临床使用.
- 基于eGFRcys和基于肌素的eGFR (eGFRcr) 之间的差异需要调查.
研究的目的:
- 在不同患者护理环境中评估eGFRcys和eGFRcr之间的差异.
- 确定导致EGFR差异的因素,包括并发症和炎症.
- 评估eGFR差异对患者存活时间的影响.
主要方法:
- 对2072名患者的回顾性分析,结合了囊癌和肌素的结果.
- 与患者护理环境和Elixhauser并发症指数相关的delta eGFRcr-cys的分析.
- 卡普兰-梅尔和考克斯的比例危险模型来评估90天的生存期.
- 在50名有系统性炎症和正常功能的门诊患者中分析EGFR差异.
主要成果:
- 与门诊患者相比,住院患者表现出较高的cysC,较低的eGFRcys和较大的delta eGFRcr-cys.
- 较高的Elixhauser并发症指数与较低的eGFRcys和增加的三角形eGFRcr-cys相关.
- 增加的三角形EGFRcr-cys与更糟糕的90天生存率有关.
- 患有炎症和正常功能的患者表现出较低的EGFRcys比EGFRcr,与红细胞异常有关.
结论:
- 炎症和并发症显著影响eGFRcys,导致与eGFRcr的差异,特别是在住院患者中.
- 联合肌素-cysC eGFR有效地减少了这些差异.
- 建议广泛采用联合eGFR,以改善功能评估.
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