血清胱抑素C诊断乙型肝炎肝硬化肾功能早期损害的意义  

Significance of serum cystatin C level for early diagnosis of renal function impairment in patients with HBV-cirrhosis

作　　者：申力军[1,2] 楚金东[2] 马雪梅[2] 金波[2] 马宇茗[3] 李莉 闫丽萍[2] 迟春生 毕茜 刘博 来文辉[2] 陈素明 吴勤[2] 于晓莉[2] 李捍卫[2] 辛绍杰[3] SHEN Li-jun;CHU Jin-dong;MA Xue-mei;JIN Bo;MA Yu-ming;LI Li;YAN Li-ping;CHI Chun-sheng;BI Qian;LIU Bo;LAI Wen-hui;CHEN Su-ming;WU Qin;YU Xiao-li;LI Han-wei;XIN Shao-jie(Chinese PLA General Hospital,Medical School of Chinese PLA,Beijing 100842,China;First Liver Cirrhosis Diagnosis and Treatment Center,302 Military Hospital of China,Beijing 100039,China)

机构地区：[1]解放军总医院/解放军医学院,北京100853 [2]解放军第三〇二医院肝硬化诊疗一中心,北京100039 [3]解放军第三〇二医院肝衰竭诊疗与研究中心,北京100039 [4]解放军第三〇二医院临床检验医学中心,北京100039

出　　处：《传染病信息》2018年第5期443-448,478,共7页Infectious Disease Information

基　　金：解放军第三〇二医院院长创新基金(QNPY2015025);十二五国家科技重大专项(2013ZX10002001-001-003)

摘　　要：目的探讨血清胱抑素C(cystatin C, Cys C)对乙型肝炎(乙肝)肝硬化患者肾功能早期损害的诊断意义。方法选取2012年12月—2017年7月于我中心住院诊治的血清CRE <1.5 mg/dl的乙肝肝硬化患者552例,回顾性分析患者临床资料,绘制血清Cys C诊断肾功能早期损害的ROC曲线。结果血清Cys C与终末期肝病模型(model of end stage liver disease, MELD)评分呈正相关,与估算肾小球滤过率呈负相关;血清Cys C、MELD评分及年龄是乙肝肝硬化患者肾功能早期损害的独立危险因素;绘制ROC曲线提示血清Cys C敏感诊断肝硬化患者肾功能早期损害建议值为1.16 mg/L。结论血清Cys C可作为临床上乙肝肝硬化患者肾功能早期损害诊断指标,其诊断效能在乙肝肝硬化不同阶段之间差异无统计学意义。ObjectiveTo explore the clinical significance of serum cystatin C （Cys C） level for the HBV-cirrhosis patients with early renal function impairment. Methods Five hundred and fifty-two patients with HBV-cirrhosis whose serum creatinine level was lower than 1.5 mg/dl, were enrolled from our center from December 2012 to July 2017. Their clinical characteristics were retrospectively analyzed. The ROC curves of serum Cys C level for early diagnosis of renal function impairment were plotted. ResultsThe serum Cys C was positively correlated with model for end-stage liver disease （MELD） score, and negatively correlated with estimated glomerular filtration rate. The serum Cys C, MELD score and age were the independent risk factors of early renal function impairment in patients with HBV-cirrhosis. The cutoff value of serum Cys C level for the early diagnosis of renal function impairment in patients with HBV-cirrhosis was 1.16 mg/L. ConclusionsThe serum Cys C level can be an effective marker for early diagnosis of renal function impairment in patients with either compensated or decompensated HBV-cirrhosis.

关 键 词：乙型肝炎 肝硬化 胱抑素C 肾功能损害 

分 类 号：R512.62[医药卫生—内科学]