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目的 探讨联合检测血清胱抑素C(CysC)和血乳酸对脓毒症急性肾损伤的早期诊断价值.方法 选择2015年10月-2017年12月入住嘉定区中心医院重症医学科的脓毒症患者112例,测定入室1~7 d血CysC、乳酸和肌酐(SCr),根据急性肾损伤网络(AKIN)诊断标准分为AKI组和非AKI组,比较两组CysC、乳酸和SCr水平,采用受试者工作特征曲线(AOC曲线)及曲线下面积(AUC)评价CysC和乳酸单用或联用时对脓毒症患者并发AKI的早期诊断价值.结果 AKI组患者CysC、乳酸和SCr水平分别在诊断脓毒症后3、3、4 d升高,与非 AKI组比较,差异均有统计学意义(P <0.05).CysC 预测脓毒症患者并发 AKI的 AUC 为 0.647 [95%C(I 0.530 , 0.763),P=0.010],CysC联合乳酸预测脓毒症并发AKI的AUC为0.796[95%C(I 0.700, 0.892), P<0.001].结论 脓毒症并发AKI患者CysC及乳酸水平明显升高,诊断脓毒症并发AKI的时间点早于SCr;联合应用CysC及乳酸可早期预测AKI的发生,优于单一指标诊断.“,”Objective To investigate the value of serum cystatin C ( CysC ) and tactic acid in early diagnosis of acute kidney injury(AKI) in patients with sepsis . Methods We conducted a retrospective analysis of the clinical data of the sepsis patients who were hospitalized to the Intensivs Care Unit of Shanghai Jiading Center Hospital from October 2015 to December 2017. According to the diagnostic criteria of AKIN for diagnosing AKI , the patients with sepsis were divided into AKI group and non-AKI group ; We compare the level of CysC , tactic acid and serum creatine ( SCr )of the patients from AKI group and non-AKI group at 1-7 day . ROC curves and AUC were employed to inves?tigate the value of the single and combined use of indicators in early diagnosis of AKI in sepsis patients . Resuts The levels of CysC , tactic acid and SCr were rising at 3 , 4 , 5 day after the diagnosis of sepsis , and the levels were signifi?cantly different from those of non-AKI group (P<0.05). The AUC of CysC in prediction of AKI in sepsis patients was 0.647〔95%C(I 0.530 , 0.763),P<0.01〕.The AUC of the value of combined use of CysC and tactic acid in prediction of AKI in sepsis patients was 0.796〔95%C(I 0.700 , 0.892),P<0.001〕.Conclusion The levels of CysC and tactic acid of sepsis patients complicated with AKI were higher and earlier than the level of SCr . The combined use of CysC and tactic acid can predict AKI earlier , which is superior to the use of a singer indicator .