血清Cys C尿mAlb和尿β_2-MG联合检测在肝硬化及原发性肝癌早期肾功能损伤中的应用价值  

The applied value of combined detection of serum cystatin C,urine microalbuminuria and β_2 microglobulin in early renal damage of live cirrhosis and primary liver cancer

作　　者：高勇[1] 张峰[1] 李团团[1] 唐振华[1] 谭林[2] 

机构地区：[1]阜阳市第二人民医院检验科,236015 [2]阜阳市第二人民医院肝病科,236015

出　　处：《安徽医学》2013年第4期484-487,共4页Anhui Medical Journal

摘　　要：目的测定慢性肝病、肝硬化和原发性肝癌(PLC)患者血清半胱氨酸蛋白酶抑制剂C(Cys C)、尿微量白蛋白(mAlb)及尿β2微球蛋白(尿β2-MG)含量,探讨三项联合检测的临床应用价值。方法分别检测67例慢性肝病、63例肝硬化、33例PLC患者和78例正常对照者血清Cys C、肌酐(SCr)、尿素(Urea)、尿mAlb及尿β2-MG含量,并分析差异。比较肝硬化、PLC患者Child-Pugh不同等级间血清Cys C、SCr、Urea、尿mAlb、尿β2-MG水平。同时比较血清Cys C、尿mAlb、尿β2-MG单独及联合检测在慢性肝病、肝硬化、PLC患者的检出率。结果肝硬化、PLC组患者血清Cys C、尿mAlb及β2-MG水平分别为(1.40±0.47,27.57±21.45,0.29±0.09)mg/L和(1.21±0.21,19.60±7.28,0.22±0.09)mg/L,均高于慢性肝病组(1.01±0.13,11.30±3.46,0.14±0.05)mg/L(P<0.05)和正常对照(0.81±0.11,11.21±2.47,0.14±0.03)mg/L(P<0.05),肝硬化组血清Cys C、尿mAlb水平明显高于PLC组(P<0.05)。肝硬化和PLC组Child-Pugh B级、C级患者血清Cys C、尿mAlb水平均明显高于Child-Pugh A级(P<0.05)。肝硬化、PLC组患者血清Cys C、尿mAlb、尿β2-MG单独及联合检测的异常检出率分别为57.1%、38.1%、31.7%、68.3%和51.5%、33.3%、30.3%、78.8%,均高于慢性肝病组(11.9%、3.0%、3.0%、16.4%)(P<0.05),且联合检测的异常检出率明显高于同组患者单独检测异常检出率(P<0.05)。结论血清Cys C、尿mAlb及尿β2-MG水平随着慢性肝病的进展和肝功能的下降而升高,且比SCr、Urea更能灵敏的反映肝硬化、PLC患者继发早期肾功能损伤。同时三项目联合检测对肝硬化、PLC患者早期肾损伤的诊断价值优于单独检测。Objective To investigate the clinical applied value of combined detection of serum cystatin C （ Cys C）, urine microalbu- minutia （mAlb） and β2microglobulin （β2 -MG） levels in patients with chronic hepatitis, liver cirrhosis and primary liver cancer（PLC）. Methods Serum Cys C, SCr, Urea, urine mAlb and β2- MG levels were detected in 67 cases of chronic hepatitis, 63 cases of liver cirrho- sis, 33 cases of PLC patients, and 78 cases of normal controls by immuno - turbidimetry. The differences of serum Cys C, urine mAlb and β2 - MG levels were analyzed among the groups. Meanwhile, the Cys C, mAlb and [β2 - MG levels were compared according to the liver func- tion Child - Push grade. The abnormal rate of combined detection of serum Cys C, mAlb and β2 - MG was compared with individual detec- tion. Results Serum Cys C, urine mAlb and β2 - MG levels were significantly higher in liver cirrhosis group [ （ 1.40 ± 0.47, 27.57 ± 21. 45, 0.29 ± 0.09） mg/L] and PLC group[ （ 1.21 ± 0.21, 19.60 ± 7.28, 0.22 ± 0.09） mg/L] than in chronic hepatitis group（ 1.01 ± 0.13, 11.30 ±3.46, 0.14 ±0.05）mg/L （P 〈0.05） and normal control group[ （0.81 ±0.11, 11.21 ±2.47, 0.14 ±0.03）mg/L] （P 〈0.05）, and Cys C and urine mAlb levels in liver cirrhosis group were higher than in PLC group （ P 〈 0.05 ）. Serum Cys C and urine mAlb levels were significantly higher in Child - Pugh B and C group than Child - Push A group between liver cirrhosis and PLC patients （ P 〈 0.05）. The ab- normal rate of Cys C , urine mAlb, β2 - MG and combined detection was significantly elevated in both liver cirrhosis group （ 57.1% , 38. 1%, 31.7%, 68.3% ） and PLC group （51.5%, 33.3%, 30.3%, 78.8% ） than that of chronic hepatitis group（ 11.9%, 3.0%, 3.0%, 16.4% ） （ P 〈 0.05 ）. Moreover, the abnormal rate of combined detection was obviously higher than that in the individual detection in cancer disease. At the same time, the diagnostic value combined with serum Cys C, urine mAlb and �

关 键 词：半胱氨酸蛋白酶抑制剂C 尿微量白蛋白 尿Β2微球蛋白 联合检测 肝硬化 原发性肝癌 

分 类 号：R575.2[医药卫生—消化系统]