血清胱抑素C在慢性肝病发展过程中的变化及临床意义——附280例检测分析

Effect of serum cystatin C in the development of chronic liver disease:an analysis of 280 cases

目的:探讨血清胱抑素C在慢性肝病发展过程中的变化及其临床意义。方法:280例肝病患者根据临床诊断指标分为肝硬化代偿组、肝硬化失代偿组、肝肾综合征组及肝癌组,各70例,同时取同期70名健康人作为对照组。采用胶乳增强免疫透射比浊法测定肝病组及对照组的血清胱抑素C水平,同时用酶法测定血清肌酐水平。比较各组两指标的差异。结果:不同时期肝病患者的血清胱抑素C水平均明显高于对照组(均为P<0.01);血清胱抑素C水平随肝硬化程度的加重而升高,而肝癌组仅高于肝硬化代偿组。在各肝病组中,仅肝肾综合征组的血清肌酐水平高于对照组(P<0.01),而其他肝病组的血清肌酐水平与对照组接近(P>0.05)。肝硬化失代偿期组、肝癌组、肝肾综合征组的血清胱抑素C异常率明显高于血清肌酐异常率(P<0.05～0.01)。结论:随着肝病病程的进展,血清胱抑素C水平逐渐升高,反映出其肾损害越发明显,监测该指标对了解慢性肝病患者的早期肾损伤具有积极的意义。

Objective： To explore the effect of serum cystatin C （ CysC ） in the development of chronic liver disease and its clinical significance. Methods： Two hundred and eighty patients with liver disease according to their clinical diagnosis were divided into liver cirrhosis compensation stage group, cirrhosis decompensation group, hepatorenal syndrome group and liver cancer group （70 cases, in each）. Seventy healthy adults were enrolled as control group. The levels of CysC were measured by latex enhanced immunoturbidimetric assay, and serum creatinine （Scr）was simultaneously analyzed by enzymatic determination. The data were compared by statistics. Results： Compared with control group, a significant statistical difference was found in serum CysC for each liver disease groups （P 〈 0. 01, in each）, and among the liver disease groups, it showed increased with the aggravation of cirrhosis. However, the Scr only showed a significant statistical difference between hepatorenal syndrome group and control group as well as the other liver disease groups（P 〈0.01 ）. The abnormal rate of CysC was higher than that of Scr in the chronic liver disease groups （P 〈 0. 05 -0. 01 ）. Conclusion： With the progress of liver disease, the level of serum CysC gradually increasesd, it reflects the kidney function is gradually damaged. Serum CysC can be one effective index in the monitoring of chronic liver disease with early renal disfunction.