梗阻性黄疸患者血清胱抑素C的表达及其经皮肝胆管穿刺引流术后的变化  

Expression of serum Cystain C in patients with obstructive jaundice and changes after percutaneous transhepatic cholangial drainage

作　　者：张毅[1] 于世平[1] 苏秀琴[1] 乔建军[1] 卫丹[1] 冯敬东[1] 

机构地区：[1]山西医科大学第二医院介入治疗科,山西太原030001

出　　处：《中国介入影像与治疗学》2015年第3期139-142,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨梗阻性黄疸患者血清胱抑素C(Cys C)的表达及经皮肝胆管穿刺引流术(PTCD)治疗前后的变化。方法收集72例梗阻性黄疸患者,行磁共振胰胆管造影(MRCP)检查明确梗阻后行PTCD。设正常组、梗阻性黄疸组(PTCD组),测定血清Cys C、肌酐(CREA)、总胆红素(TBIL)水平,比较各组指标的差异。结果 PTCD组术前、PTCD组术后、正常组间TBIL、Cys C水平比较差异均有统计学意义,且PTCD组术前、术后均高于正常组(P<0.001);PTCD组术前、PTCD组术后、正常组间CREA水平无明显差异(P>0.05)。Cys C与CREA、TBIL均呈正相关性(r=0.320、0.265,P均<0.001)。治疗后Cys C和TBIL较治疗前明显下降(P<0.01)。PTCD组术前Cys C的异常率为58.33%(42/72),CREA的异常率为11.11%(8/72);PTCD组术后Cys C的异常率为19.44%(14/72),CREA的异常率为8.33%(6/72);正常组Cys C、CREA的异常率为0。结论 Cys C既可反应梗阻性黄疸高胆红素血症毒性,也可作为梗阻性黄疸并发肾功能异常的早期敏感指标。Objective To investigate the expression of serum Cystain C（Cys C）in patients with obstructive jaundice and its changes after percutaneous transhepatic cholangial drainage（PTCD）.Methods Seventy-two patients with obstructive jaundice were enrolled.The obstructive defined with magnetic resonance cholangiopancreatography（MRCP）,and all patients treated with PTCD.PTCD group（n=72）and control group（n=20）were designed in the study.The levels of Cys C,serum creatinine（CREA）and serum total bilirubin（TBIL）were measured to evaluate the differences between the two groups.Result The levels of Cys C and TBIL had a significant statistical difference among pre-PTCD,post-PTCD and control group,which significantly increased in pre-PTCD and post-PTCD compared with those in control group（P〈0.001）.There were no statistically significant differences in CREA level among pre-PTCD,post-PTCD and control group（all P〉0.05）.The levels of CREA and TBIL were positively correlated with the Cys C level（r=0.320,0265,both P〈0.001）.The levels of Cys C and TBIL significantly decreased in post-PTCD（P〈0.01）.The abnormal rates of Cys C and CREA were 58.33%（42/72）and 11.11%（8/72）respectively in pre-PTCD,which were 19.44%（14/72）and 8.33%（6/72）in post-PTCD.The abnormal rates of Cys C and CREA were 0in control group.Conclusion Cys C can not only reflect hyperbilirubinemia toxicity of obstructive jaundice,but also be as a sensitive index for early stage of obstructive jaundice complicated with abnormal renal function.

关 键 词：胱抑素C 黄疸 梗阻性 经皮肝胆管穿刺引流术 

分 类 号：R575[医药卫生—消化系统] R815[医药卫生—内科学]