摘要
目的比较血清胱抑素C(Cystatin C,cys-C)和血肌酐(Scr)在肝硬化失代偿期肾损伤及疾病预后等方面的诊断效能。方法选择肝硬化失代偿期患者82例,测定CysC、Scr及肌酐清除率(Ccr),设定临界Ccr值,比较不同Ccr水平Scr及Cys-c的差别,通过ROC曲线分析比较两项指标的诊断效能。随访12个月,比较不同初始Ccr值患者病死率以及不同结局的患者初始CysC、Scr值。结果①以Ccr<60mL/min为临界值进行分组,A组(Ccr≥60mL/min)40例,B组(Ccr<60mL/min)42例,两组初始血肌酐值差异不显著,Cys-C值B组显著高于A组,ROC曲线分析提示Cys-C AUC值显著大于Scr;②随访病例74例,全因死亡18例,B组病死率显著高于A组。死亡患者初始Scr及Cys-C均显著高于对照组。结论 CysC能更准确的反映肝硬化患者肾小球滤过功能,并且与患者预后有更高相关性,对肝硬化早期肾损害有较高诊断价值。
Objective To compare serum Cys-C with Scr in the assessment of early kidney injury and prognosis for the decompensated cirrhotic patients. Method Recruit decompensated cirrhotic patients in ours hospital, examine their serum Cys-C with Scr and calculate the creatinine clearance rate.Define a critical value and compare the average serum Cys-C and Scr values in certain Ccr range.Follow up the cases for 12 months, compare the mortality between groups and their initial serum Cys-C and Scr value.Result ①82 cases were recruited, Ccr〈60mL/min was defined as the critical value and the cases were grouped .Consequently group A （Ccr t〉 60mL/min）possess 40 cases and group B（Cct〈60mL/min）42 cases.Their initial Scr had no significant difference while the Cys-C value of group B was significantly higher than that of group A .For ROC curve analysis, Cys-C showed bigger AUC value than Scr; ②74 cases had finished the follow-up study while 18 cases died.The mortality of group B were higher than those of group A.Meanwhile, significantly higher Scr and Cys-C were shown in the case who were dead and the difference of Cys-C between the groups was especially obvious. Conclusion Serum Cys-C makes more accurate reflex of GFR for cirrhotic patients than Scr. It shows high relativity with the prognosis and high diagnostic value for the early kidney injury for cirrhotic patients.
出处
《中国医药指南》
2013年第35期21-22,共2页
Guide of China Medicine
关键词
胱抑素C
血肌酐
肝肾综合征
肌酐清除率
Cystatin C
Serum creatinine
Hepatorenal syndrome
Creatinine clearance rate
