血清胱抑素C对肝硬化病人肾功能损害的早期诊断价值研究

目的 探讨血清半胱氨酸蛋白酶抑制剂C(Cys C)检测对肝硬化病人肾功能损害早期诊断的意义.方法 测定76例肝硬化病人24 h肌酐清除率(Ccr)以及血清肌酐(SCr)和血清Cys C水平.以CCr＜80 ml/min/1.73 m2作为肾功能损害诊断标准,采用t检验、相关性分析和ROC曲线分析探讨Cys C的诊断价值.结果 在Child分级肝损害病人的肾功能评估能力比较中,Cys C能灵敏反映CCr变化,而Scr的反映能力明显低于Cys C.SCr与CCr有着显著的负相关性(CysC:r=-0.763,P＜0.001;SCr:r=-0.571,P＜0.01),而Cys C的相关系数较高.ROC曲线分析显示Cys C的曲线下面积(AUC)值明显高于SCr(0.830比0.612).结论 与SCr比较,Cys C能更准确地早期发现肝硬化病人的肾功能损害,常规监测肝硬化病人Cys C水平,对预防肝肾综合征的发生具有积极意义.

Value of serum cystatin C for early diagnosis of renal damage in patients with liver cirrhosis

Objective To investigate the diagnostic value of serum Cystatin C for early detection of renal damage in patients with liver cirrhosis. Methods 24-h creatinine clearance (CCr), serum level of cystatin C (CysC) and serum creatinine were measured in 76 patients with cirrhosis and t-test,Pearson's correlation test and ROC curve were used to evaluate the diagnostic significance of Cys C.Results The increase in Cys C level was associated with a decrease of CCr in the patients. Both Cys C and SCr were inversely correlated with CCr ( CysC: r =- 0. 763, P ＜ 0. 001; SCr: r=-0. 571,P＜0.01). Meanwhile, the area under the ROC curve was significantly higher in Cys C than in SCr (0. 830 vs. 0. 612). Conclusion Cystatin C is a more accurate and sensitive marker of renal diagnosis in liver cirrhosis. Detection of Cys C level in cirrhotic patients is of great significance for the prevention of liver-kidney syndrome.