比较血清胱抑素C及肌酐对肝肾综合征的诊断价值  

A Trial to Compare Serum Cys-C with Serum Creatinine in the Diagnosis of Hepatorenal Syndrome

作　　者：曾贵林[1] 谭妙玲[1] 

机构地区：[1]广东省江门市新会区人民医院,广东江门529100

出　　处：《中国医药指南》2013年第35期21-22,共2页Guide of China Medicine

摘　　要：目的比较血清胱抑素C(Cystatin C,cys-C)和血肌酐(Scr)在肝硬化失代偿期肾损伤及疾病预后等方面的诊断效能。方法选择肝硬化失代偿期患者82例,测定CysC、Scr及肌酐清除率(Ccr),设定临界Ccr值,比较不同Ccr水平Scr及Cys-c的差别,通过ROC曲线分析比较两项指标的诊断效能。随访12个月,比较不同初始Ccr值患者病死率以及不同结局的患者初始CysC、Scr值。结果①以Ccr<60mL/min为临界值进行分组,A组(Ccr≥60mL/min)40例,B组(Ccr<60mL/min)42例,两组初始血肌酐值差异不显著,Cys-C值B组显著高于A组,ROC曲线分析提示Cys-C AUC值显著大于Scr;②随访病例74例,全因死亡18例,B组病死率显著高于A组。死亡患者初始Scr及Cys-C均显著高于对照组。结论 CysC能更准确的反映肝硬化患者肾小球滤过功能,并且与患者预后有更高相关性,对肝硬化早期肾损害有较高诊断价值。Objective To compare serum Cys-C with Scr in the assessment of early kidney injury and prognosis for the decompensated cirrhotic patients. Method Recruit decompensated cirrhotic patients in ours hospital, examine their serum Cys-C with Scr and calculate the creatinine clearance rate.Define a critical value and compare the average serum Cys-C and Scr values in certain Ccr range.Follow up the cases for 12 months, compare the mortality between groups and their initial serum Cys-C and Scr value.Result ①82 cases were recruited, Ccr〈60mL/min was defined as the critical value and the cases were grouped .Consequently group A （Ccr t〉 60mL/min）possess 40 cases and group B（Cct〈60mL/min）42 cases.Their initial Scr had no significant difference while the Cys-C value of group B was significantly higher than that of group A .For ROC curve analysis, Cys-C showed bigger AUC value than Scr; ②74 cases had finished the follow-up study while 18 cases died.The mortality of group B were higher than those of group A.Meanwhile, significantly higher Scr and Cys-C were shown in the case who were dead and the difference of Cys-C between the groups was especially obvious. Conclusion Serum Cys-C makes more accurate reflex of GFR for cirrhotic patients than Scr. It shows high relativity with the prognosis and high diagnostic value for the early kidney injury for cirrhotic patients.

关 键 词：胱抑素C 血肌酐 肝肾综合征 肌酐清除率 

分 类 号：R575[医药卫生—消化系统]