慢性乙型肝炎患者血清胱抑素C水平与其肝损伤程度的关系

目的 探讨慢性乙型肝炎(CHB)患者血清胱抑素C(CysC)水平与其肝损伤程度的关系。方法 选择2014年1月～12月间铜陵市立医院收治的CHB患者65例,依据CHB临床分度标准将其分为重度组22例、中度组19例、轻度组24例,另选择同期体检健康者26例作为健康对照组,采用免疫比浊法检测血清CysC,同时检测尿素(Urea)、血肌酐(SCr)、总胆红素(TBil)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和γ-谷氨酰转肽酶(γ-GT),并根据性别、年龄、SCr按公式计算肾小球滤过率(eGFR),比较各组CysC,Urea,SCr和eGFR,并分析CHB患者血清CysC与TBil,ALT,AST和γ-GT的相关性。结果 CHB重度组、CHB中度组、CHB轻度组及健康对照组血清CysC水平依次为1.35±0.23,1.18±0.24,1.02±0.20和0.75±0.18 mg/L; CHB各临床分度组血清CysC水平均高于健康对照组,差异均有统计学意义(t=5.587～10.852,均P<0.01); 血清CysC水平CHB重度组高于CHB中度组,CHB中度组又高于CHB轻度组,差异均有统计学意义(t分别为2.331,2.323,均P<0.05); 组间Urea,SCr,eGFR差异均无统计学意义(F=0.288～0.383,均P>0.05)。CHB患者血清CysC与TBil,ALT,AST,γ-GT均呈正相关(r=0.246～0.293,均P<0.05)。结论 血清CysC水平与CHB肝损伤程度有关,其可作为观察CHB患者肝损伤程度的指标。

Relationship between the Level of Serum Cystatin Cand Degree of Liver Damage in Patients with Chronic Hepatitis B

Objective To investigate the relationship between the level of serum cystatin C(CysC)and degree of liver damage in patients with chronic hepatitis B(CHB).Methods 65 patients with CHB and 26 healthy individuals were selected as healthy controls in Tongling municipal hospital from January to December 2014.Patients with CHB were divided intosevere CHB group(n=22),moderate CHB group(n=19)and mild CHB group(n=24)according to clinical grading standard.Serum CysC was measured by immunonephelometry method.Urea,serum creatinine(SCr),Total bilirubin(TBil),alanine aminotransferase(ALT),aspartate aminotransferasein(AST)and γ-glutamyl transpeptidase(γ-GT)were also measured.Estimated glomerular filtration rate(eGFR)was estimated according to gender,age,SCr.The date from different groups were analyzed statistically.Results The levels ofserum CysC in severe CHB group,moderate CHB group,mild CHB group and healthy controls were 1.35±0.23,1.18±0.24,1.02±0.20 and 0.75±0.18 mg/L.Thelevels of serum CysC in severe CHB group,moderate CHB group and mild CHB groupwere all higher healthy controls(t=5.587～10.852,all P<0.01).Thelevel of serum CysC in severe CHB group was higher moderate CHB group and moderate CHB group was higher mild CHB group(t=2.331,2.323,P<0.05).Urea,SCr and eGFR were all not statistically significant between any two in each group(F=0.288～0.383,P>0.05).The level of serum CysC were positively correlated with TBil,ALT,AST and γ-GT in patients with CHB(r=0.246～0.293,P<0.05).Conclusion The level of serum CysC may becorrelated with degree of liver damage in patients with CHB,which indicate thatserum CysC may be used as an important index to evaluate degree of liver damagein patients with CHB.