血清CysC检测在肝硬化肾功能损害评估中的价值

Significance of cystatin C in evaluation of renal function in patients with liver cirrhosis

目的探讨肝硬化患者血清中胱抑素C(Cys C)水平变化在评估肾功能中的临床意义。方法在118例肝硬化(A组)、48例慢性乙型肝炎(B组)患者及30例健康人(C组)采用免疫比浊法检测血清Cys C和β2微球蛋白(β2-MG)水平,酶法测定血清肌酐(SCr)、尿素氮(BUN)水平。结果 A组血清Cys C为(1.29±0.33)mg/L,明显高于B组和C组的(0.98±0.21)mg/L、(0.92±0.15)mg/L(P<0.01)。A组SCr、BUN和β2-MG水平均明显高于B组(P<0.01)。A组血清Cys C与SCr、BUN及β2-MG均呈正相关(r=0.502、r=0.456、r=0.752,P<0.01)。A组血清Cys C异常率为75.4%,明显高于SCr的5.9%、BUN的17.8%和β2-MG的22.0%(P<0.01)。结论血清Cys C是监测肝硬化患者早期肾功能损害一项灵敏的指标。

Objective To explore the significance of cystatin C（Cys C） in the evaluation of renal function in patients with liver cirrhosis. Methods Serum levels of Cys C and β2 microglobulin （β2-MG） were detected by immunoturbidimetric assay and serum creatinine （SCr） and blood urea nitrogen（BUN） were measured by enzymatic method in 118 patients with liver cirrhosis（group A） ,48 patients with chronic hepatitis B（group B） and 30 healthy people（group C）. Results Serum Cys C in group A was （1.29±0.33） mg/L,which was higher than （0. 98±0. 21） mg/L in group B and （0. 92±0.15） mg/L in group C（P〈0. 01）. The SCr,BUN and β2 MG levels were higher in group A than those in group B（P〈0. 01）. Serum level of Cys C was positively correlated to that of SCr, BUN and β2-MG（r= 0. 502, r= 0. 456, r= 0. 752, P〈0. 01）. The abnormality rate of Cys C was 75.4 % in group A,which was significantly higher than that of SCr （5.9%）, BUN （17.8%） and β2-MG （22.0%） （P〈0. 01）. Conclusion Serum Cys C can be used as a sensitive indicator of early renal damage in the patients with cirrhosis.