肝病患者血清胱抑素C水平变化及其临床意义

目的探讨肝病患者血清胱抑素C(CysC)的水平变化。方法检测血清肌酐浓度正常的61例慢性肝炎,22例重型肝炎,43例肝炎肝硬化,26例原发性肝癌及50例健康者(对照组)血清CysC、丙氨酸氨基移换酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、γ-谷氨酰转移酶(GGT)水平,分析血清Cys C与ALT、AST、TBIL、GGT的相互关系,观察肝病治疗前后血清CysC变化。结果慢性肝炎组、重型肝炎组、肝硬化组、肝癌组和对照组血清CysC分别为(1.12±0.26)mg/L、(1.32±0.36)mg/L、(1.54±0.24)mg/L、(1.38±0.30)mg/L和(0.76±0.15)mg/L。各肝病组血清Cys C均显著高于对照组(P<0.01),重型肝炎组、肝硬化组和肝癌组均显著高于慢性肝炎组(P<0.05),肝硬化组显著高于重型肝炎组(P<0.05),肝硬化组与肝癌组差异无统计学意义。血清CysC与ALT、AST、TBIL、GGT呈正相关(P<0.05)。肝病患者治疗后血清Cys C无明显变化。结论肝病患者血清CysC水平明显增高,血清CysC可作为肝功能评价指标,对监测肝病病情进展具有重要参考价值。

Clinical significance of changes in serum cysC levels in patients with liver disease

Objective To study the changes in serum cystatin C （ Cys C） levels in patients with liver disease. Methods The levels of serum Cys C,alanine aminotransferase enzyme （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBIL）,gama - glutamyl transferase （GGT） were assayed in patients with normal serum creatinine（CERA） concentration, including 61 patients with chronic hepatitis,22 patients with severe hepatitis,43 patients with hepatocirrhosis,26 patients with hepatocarcinoma and 50 healthy subjects. And the relationship between Cys C and ALT, AST, TBIL, GGT,PT,and the change, of serum CysC before and after the treatment of liver disease was analyzed. Results The levels of serum Cys C were 1.12±0.26 mg/L, 1.32±0.36 rag/L, 1.54 ±0.24 rag/L, 1.38±0.30 rag/L, and 0.76±0.15 mg/L in chronic hepatitis group, severe hepatitis group, hepatocirrhosis group, hepatocar- cinoma group, and control group, respectively. The level of serum CysC was significantly higher in all the liver disease group compared with the control group （P 〈 0.01 ）, It was significantly higher in severe hepatitis group, hepatocirrhosis group and hepatocarcinoma group than in the chronic hepatitis group （ P 〈 0.05 ）. It was markedly higher in the hepatoeirrhosis group than in the severe hepatitis group （ P 〈 0.05 ）. There was no statistically significant difference between hepatocirrhosis group and the hepatocarcinoma group （ P 〉 0.05 ）. There was positive relationship between CysC and ALT, AST, TBIL, GGT （ P 〈 0.05 ）. There is no significant variation of the level of serum CysC in liver disease patients after treatment （ P 〉 0.05 ）. Conclusions The level of serum CysC is significantly higher in patients with liver disease ,which is considered as a precise index for liver function evaluation and has significant reference value for monitoring the progression of liver disease.