Clinical Studies Of Dynamic Changes In The Renal Injury Indicators Of Acute Paraquat Poisoning

Objective:To investigate the clinical significance of dynamic changes of cystatin (cystatin C), serum creatinine (SCr), blood urea nitrogen (BUN) and urinary protein in renal injurys with paraquat poisoning.Methods:According to the clinical manifest and curative effect,the clinical information was analyzed retrospectively in52cases of acute paraquat poisoning, survival after three weeks as the standard, divided into35cases with the survival group,17cases with death group. Poisoning patients were taken a fasting blood5ml and the middle of urina sanguinis on the1st,3rd,7th,14th,21st d and after one month of the poisoning. Then the levels of serum Cystatin C (CysC), creatinine(Cr), blood urea nitrogen (BUN) and Urinary protein were detected by automatic biochemistry analyzer and pathologica. Thirthy healthy subjects were randomly selected as normal control group, and discharged kidney disease and other diseases of urinary system history. The healthy subjects were taken a fasting blood5ml and the middle of urina sanguinis on the day of examination.Results:Acute paraquat poisoning can cause varying degrees of renal injury. Compared with the healthy control group, the level of serum Cystatin C in the survival group and death group were significantly increased, and had statistical signifi-cance (P<0.05). Compared with the serum creatinine (SCr), blood urea nitrogen (BUN), the level of serum Cystatin C in the survival group and death group were significantly increased. Compared with the survival group, the level of serum Cystatin C, serum creatinine (SCr)and blood urea nitrogen (BUN) in the death group were significantly increased and had statistical significance (P<0.05). The level of serum Cystatin C increased with the serum creatinine (SCr), and both have a certain correlation. The relative increase in serum CysC were significantly higher than serum creatinine (SCr) and blood urea nitrogen (BUN) those on the1st,2nd and3rd d of the poisoning. The level of serum cystatin (cystatin C), serum creatinine (SCr) and blood urea nitrogen (BUN) were significantly and dynamic increased between poisoning group and controls, and had statistical signifi-cance (P<0.05). The level of serum cystatin (cystatin C), serum creatinine (SCr) and blood urea nitrogen (BUN) were decreased to some extent on the14th d of the poisoning. The decrease in serum CysC were lower than serum creatinine (SCr) and blood urea nitrogen (BUN). There were29cases of patients with renal biochemical indicators to the normal range on the21st d of the poisoning, and increased to31cases after one month of the poisoning.It is explained that paraquat poisoning-induced renal damage is reversible. The positive rate of urinary protein is relatively high on the on the1st,2nd and3rd d of the poisoning.Conclusion:Serum cystatin C is sensitive indicator to reveal the early-stage nephropathy in paraquat poisoning patients, have higher value of clinical applications in the early diagnosis of the early-stage nephropathy of paraquat poisoning, which sensitivity is higher than serum creatinine (SCr)and blood urea nitrogen (BUN).