HBV相关慢性肝炎、肝硬化和肝衰竭患者肾功能早期损伤指标观察  

Observation of early renal injury indexes in patients with chronic HBV-related chronic hepatitis,liver cirrhosis and hepatic failure

作　　者：阎双缓[1] 何立芳[2] 陈永良 张红霞[1] 高朋彬[1] YAN Shuanghuan;HE Lifang;CHEN Yongliang(Department of Infectious Diseases,The Fifth Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050021,China)

机构地区：[1]河北省石家庄市第五医院,050021 [2]河北省唐山市丰润区人民医院

出　　处：《河北医药》2019年第19期2979-2982,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题(编号:20181077)

摘　　要：目的 了解乙型肝炎病毒(HBV)相关慢性肝炎、肝硬化和肝衰竭患者肾功能早期损伤的检测指标。方法 选取2016年1月至2017年12月住院治疗的血清肌酐正常的慢性HBV感染患者303例进行调查,患者分为慢性乙型肝炎组(A组)、乙型肝炎肝硬化组(B组)及HBV相关肝衰竭组(C组)。进行肾小球滤过率(eGFR)、尿微量白蛋白(MA)、血清胱抑素C(CysC)及血β2微球蛋白(β2-MG)检测。结果 3组间比较,A组患者eGFR高于B组及C组,但3组间差异无统计学意义(P>0.05)。尿MA在3组均为异常,但3组间均差异无统计学(P>0.05)。A组血β2-MG低于B组及C组(P<0.05),B和C组比较差异无统计学意义(P>0.05)。A组血CysC低于B组及C组(P<0.05),B组低于C组(P<0.05)。A组eGFR异常率低于B组及C组(P<0.05),B组与C组差异无统计学意义(P>0.05)。3组尿MA异常率差异均无统计学意义(P>0.05)。A组血β2-MG异常率低于B组及C组(P<0.05),而B组与C组差异无统计学意义(P>0.05)。A组血CysC异常率低于B组及C组(P<0.05),B组低于C组(P<0.05)。结论 HBV相关慢性肝炎、肝硬化和肝衰竭患者中,尿MA、血β2-MG及血清CysC在反映肾损伤风险方面各有优势,尤其血清CysC及血β2-MG的特异性和敏感性互为补充,为临床更早发现肾功能受损有重大意义。Objective To investigate the early renal injury indexes in patients with chronic HBV-related chronic hepatitis,liver cirrhosis and hepatic failure.Methods A total of 303 patients with chronic HBV infection and normal creatinine levels,who were treated in our hospital from January 2016 to December 2017,were divided into chronic hepatitis B group(group A),hepatitis B-induced cirrhosis group(group B)and HBV-related hepatic failure group(group C).The glomerular filtration rate(eGFR),urinary albumin(MA),serum cystatin(CysC)andβ2 microglobulin(β2-MG)were detected and compared.Results The eGFR levels in group A were higher than those in group B and group C,but there were no significant differences among the three groups(P>0.05).MA levels were found abnormal in the three groups,but there were no significant differences among the three groups(P>0.05).Theβ2 MG levels in group A were significantly lower than those in group B and C(P<0.05),but there were no significant differences between group B and group C(P>0.05).The CysC levels in group A were significantly lower than those in group B and C(P<0.05),which in group B were significantly lower than those in group C(P<0.05).Moreover the abnormality rate of eGFR in group A was significantly lower than that in group B and C(P<0.05),however,there was no significant difference between group B and group C(P>0.05).Furthermore,there was no significant difference in the abnormality rate of MA among the three groups(P>0.05).And the abnormality rate ofβ2 MG in group A was significantly lower than that in group B and group C(P<0.05),but there was no significant difference between group B and group C(P>0.05).The abnormality rate of CysC in group A was significantly lower than that in group B and C(P<0.05),which in group B was significantly lower than that in group C(P<0.05).Conclusion For patients with chronic HBV-related hepatitis,liver cirrhosis and hepatic failure,MA,β2-MG and CysC have their own advantages in indicating the risk of renal injury,especially the specificity and sen

关 键 词：肾小球滤过率 尿微量白蛋白 血Β2微球蛋白 血清胱抑素C 

分 类 号：R575.1[医药卫生—消化系统]