ABO血型及胱抑素C与乙型肝炎肝硬化失代偿期相关性研究

Study on the correlation of ABO blood group and serum cystatin C level and decompensated hepatitis B cirrhosis

目的探讨ABO血型及胱抑素C与乙型肝炎肝硬化失代偿期的相关性，以便更好地指导临床诊治工作。方法回顾性分析472例乙型肝炎肝硬化失代偿期患者性别、年龄、乙型肝炎家族史、乙型肝炎病毒标记、肝功能分级、门静脉高压及并发症与ABO血型分布情况，比较胱抑素C与肌酐水平差异及其与肝功能分级关系，并与681例健康人群进行对比。结果乙型肝炎肝硬化失代偿期患者中，A型血发生率最高。各年龄组中ABO血型分布比较差异无统计学意义（P〉0．05）。AB型血患者中有乙型肝炎家族史、门静脉宽度〉1．5cm、食管静脉曲张、有并发症及肝功能分级Child-PughC级所占比例均明显高于其他血型，差异有统计学意义（P〈0．01）。胱抑素C水平随着肝功能分级升高而逐渐升高，差异有统计学意义（P〈0．05）。结论A型血的人群具有肝硬化的高危因素，AB型血的肝硬化患者其病情发展较其他血型者更严重。肝硬化失代偿期患者胱抑素C水平与尿素氮、肌酐相比明显高于健康者，胱抑素C水平随肝功能分级升高而呈升高趋势，同时胱抑素C具有成为肝功能分级的良好指标的潜力。

Objective To explore the correlation of ABO blood group and serum cystatin C level and decompensated hepatitis B cirrhosis. Methods Retrospectively analysed the clinical data of 472 patients with deeompensated hepatitis B cirrhosis, and compared with 681 healthy control volunteers. All the informations such as gender,age,family history of liver disease,hepatitis B virus infection,hepatic function classification, complications of portal hypertension and the distribution of ABO blood group were observed. Results The highest incidence of decompensated hepatitis B cirrhosis was found in A blood group. There was no significant difference in the distribution of ABO blood group for patients with different age （P 〉 0.05 ）. Significant correlations were observed between AB blood group and family history of hepatitis B patients, expansion of the portal veines 〉 1.5 cm,esophageal varices,cirrhosis complications,hepatic function elassification（P 〈 0.01 ）. Cystatin C expression was increased with hepatic function classification （P 〈 0.05 ）. Conclusions The risk of liver cirrhosis is increased in patients with A blood group. Compare with other blood group, patients with AB blood group has a serious progression. The level of nitrogen, creatinine, cystatin C in decompensated cirrhosis are significantly higher than healthy controls. The level of cystatin C expression is increased with hepatic function classification. Cystatin C may be a potential marker in the classification of hepatic function.