肝肾综合征患者血清胱抑素C检测的临床评价

目的探讨血清胱抑素C（CysC）检测在肝肾综合征（HRS）诊断中的价值。方法以24小时肌酐清除率（24h-Ccr）作为肾小球滤过率（GFR）评估标准,将72例晚期肝硬化患者分为HRS组和非HRS组,同时设40例健康人作为正常对照组。所有待测者均测定血清CysC、血肌酐（Scr）、尿肌酐（Ucr）和血尿素氮（BUN）。比较分析各组间24-Ccr、CysC、Scr与BUN的水平差异、CysC、Scr、BUN与24-Ccr的相关性及其诊断的准确性。结果 CysC水平在HRS组与非HRS组间有非常显著性差异（P〈0.01）,而Scr与BUN在HRS与非HRS组间无显著性差异;CysC与24-Ccr的相关性最好,诊断灵敏度和特异度均优于Scr和BUN。结论 CysC能灵敏反映肝硬化患者肾功能早期损害,是评估HRS患者GFR较理想的指标。

Clinical evaluation of detection of serum Cystatin C in patients with hepatorenal syndrome

Objective To explore the clinical value of detection of serum cystatin C （CysC）in diagnosis of hepatorenal syndrome. Methods With 24-hour creatinine clearances（24-Ccr）as a evaluative criteria for glomerular filtration rate（GFR）,72 patients with decompensated liver cirrhosis were divided into two groups ：HRS group and non-HRS group. 40 healthy persons were served as normal controls. The levels of serum CysC, serum creatinine （Scr）,urine creatinine （Ucr）and blood urea nitrogen （BUN）were detected in all participants. The differences of levels of 24-Ccr,CysC ,Scr and BUN between groups were compared. The relativity of 24-Ccr with serum CysC ,Scr and BUN and their diagnostic accuracy were analysed,respectively. Results There were significant differences of levels of serum CysC HRS group and non-HRS group （P〈0.01）. But no significant differences of levels of Scr or BUN could be found between HRS group and non-HRS group. CysC was better correlated with glomerular filtra- tion rate from 24h-Ccr than Scr and BUN. CysC revealed better sensitivity and specificity than Scr and BUN in diagnosis of hepatorenal syndrome. Conclusion CysC was a sensitive indicator in judgement of early renal damage of liver cirrhosis patients and assessment of GFR in HRS patients.