CRRT在地震CS患者肌肉损伤和肾功能衰竭中的诊断评估

摘要

目的 对被地震垮塌物埋压超过100小时的15例挤压综合征(Crush Syndrome CS)伤者血清中心肌标志物和胱抑素C浓度进行检测,并运用连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)进行疗效评估.方法 使用BECKMAN-LX20全自动生化分析仪,检测由地震所致的CS伤员接受CRRT疗法后血清中CK、CK-MB、Tnl、Myo和胱抑素C的浓度.结果 CS伤员的CK、CK-MB、Tnl、Myo、胱抑素C水平明显增高,与正常对照组比较有显著性差异(P＜0.05),有统计学意义.经过CRRT治疗一段时间后,CK、CK-MB、Tnl、Myo、胱抑素C水平有所下降,部分处于正常水平.结论 CK、CK-MB、Tnl、Myo是肌肉损伤的标志物,而胱抑素C是目前临床判断肾脏功能的一个重要指标,了解地震伤员特别是CS伤员的CK、CK-MB、Tnl、Myo、胱抑素C变化,为临床救治、病情监控及疗效评估等提供依据.%Objective 15 Crush Syndrome patients that intered over 100 hours by earthquake fall objects tested the Cardiac Muscle Sign Substance and Cystatin-C level,use CRRT scheme to evaluate the curative effect.Methods Use BECKMAN-LX20 auto-biochemical apparatus to test Crush Syndrome patient's CK、CK-MB、Tnl、Myo and Cystatin-C level;Results The Crush Syndrome patient's CK、CK-MB、Tnl、Myo and Cystatin-C level raise fleetly.It is observably difference that Crush Syndrome patients compare with normal people (P＜0.05).By period of time in CRRT,the CK、CK-MB、Tnl、Myo and Cystatin-C level was fall and a part was natural.Conclusion CK、CK-MB、Tnl、Myo are very important Sign Substance in muscle damnification and Cystatin-C is a important guide line that judged kidney function for clinic.For understand The Crush Syndrome patient's Cystatin-C level change,it can provide important gist such as clinic cure、state of an illness control、curative effect evaluate and so on.