胱抑素C在评价肝移植患者围手术期肾小球滤过功能中的应用  

Cystatin C in the evaluation of glomerular filtrate function in the perioperative patients undergoing liver transplantation

作　　者：赖添顺[1] 郭振辉[1] 蔡敏捷[1] 苏磊[2] 霍枫[3] 唐柚青[2] 孙杰[1] 

机构地区：[1]广州军区广州总医院MICU科,510010 [2]广州军区广州总医院ICU科,510010 [3]广州军区广州总医院肝胆外科,510010

出　　处：《实用医学杂志》2008年第18期3123-3125,共3页The Journal of Practical Medicine

基　　金：广州市科委攻关引导项目基金资助项目(编号:03Z-E0261)

摘　　要：目的:探讨胱抑素C(CysC)在评价肝移植患者围手术期肾小球滤过功能(GFF)变化中的应用价值。方法:观察我院行肝移植手术的44例患者术前,术后第1、2、3天及术后第10天的血清CysC、肌酐(Cr)及尿素氮(BUN)的变化情况,并作两两相关性分析。结果:CysC水平术前已高于正常,而术后第1天较术前显著降低(P<0.05),但术后第2天及以后与术前均无统计学差异。而Cr、BUN水平术前正常,术后早期升高后下降,到术后第3天Cr与术前相比无统计学差异,而BUN则有显著统计学差异(P<0.01)。患者围手术期CysC与Cr,CysC与BUN,Cr与BUN均有一定的相关性(P<0.01),且术后3d内均较术前升高,而第10天CysC与BUN、Cr的相关性较前均下降(r分别为0.56和0.59,P<0.01);而术后BUN与Cr相关系数仍较高,为0.81(P<0.01)。结论:CysC、Cr及BUN在评价肝移植患者围手术期GFF上均有一定的缺点,故应联合CysC、Cr及BUN以更准确地评价肝移植患者围手术期GFF。Objective To investigate the clinical value of cystatin C （CysC） in the evaluation of glomerular filtrate function （GFF） in the perioperative patients undergoing liver transplantation. Methods Serum levels of CysC and creatine （Cr） and blood urea nitrogen （BUN） levels were detected in 44 patients before liver transplantation and on days 1, 2, 3, and 10 after transplantation, and their correlations were analyzed. Results The mean CysC level was abnormally high before surgery; it decreased significantly at the same day of the procedure （P 〈 0.05） but did not differ on day 1 from the baseline. Levels of Cr and BUN were increased postoperatively and then decreased, as compared with the normal baselines. The BUN level on day 10 but not Cr differed significantly from the baseline （P 〈 0.01）. There was significant relationship of either CysC and Cr, CysC and BUN, or Cr and BUN （P 〈 0.01） and each relationship was increased on days 1 to 3. However, the relationship of either CysC and Cr or CysC and BUN declined on day 10 （r = 0.56 and r = 0.59, respectively; P 〈 0.01） while that of BUN and Cr still maintained at a higher level （r = 0.81, P 〈 0.01 ）. Conclusions CysC, Cr, or BUN alone has its own limitation in assessing perioperative GFF. Thus these three biochemical markers should be combined for the more accurate evaluation.

关 键 词：肝移植 手术期间 肾小球滤过功能 胱抑素C 肌酐 尿素氮 

分 类 号：R657.3[医药卫生—外科学]