胱抑素C和肝动脉阻力指数在肝硬化患者中的临床意义

Clinical significance of cystatin C and hepatic artery resistance index in patients with liver cirrhosis

目的评价胱抑素C(CysC)水平和肝动脉阻力指数(HARI)在评价肝硬化患者肝脏纤维化的临床意义。方法选择2016年12月至2018年9月期间接受检查和治疗的63例肝硬化患者作为横向研究对象,对照组由30位年龄和性别相匹配的健康人群组成。对健康人群和肝硬化患者进行血清学检测、腹部多普勒超声检测和上腹部内窥镜检测。结果与对照组相比,胱抑素C在肝硬化患者中的明显升高(P=0.036),与对照组(0.65±0.05)相比,研究组的HARI平均值显著增加(0.73±0.01,P<0.001)。HARI和胱抑素C之间存在显著相关性(rs=0.531,P<0.001)。ROC曲线下HARI指数面积远高于CysC。Child?Pugh分期阶段与胱抑素C水平具有相关性(P=0.037)。结论肝动脉阻力指数是一个比胱抑素C更准确的肝纤维化评价指标,而在肝硬化阶段胱抑素C是此肝动脉阻力更好的评价指标。

Objective To evaluate the clinical significance of cystatin C(CysC)levels and hepatic artery resistance index(HARI)in evaluating cirrhosis in patients with fibrosis.Methods A cross?sectional study of 63 patients with cirrhosis who underwent examination and treatment from December 2016 to September 2018 was selected.The control group consisted of 30 healthy individuals matched for age and sex.Serological testing,abdominal Doppler ultrasonography and upper abdominal endoscopy were performed in healthy people and patients with cirrhosis.Results Compared with the control group,Cystatin C was significantly higher in patients with cirrhosis(P=0.036).Compared with the control group(0.65±0.05),the mean value of HARI in the study group significantly increased(0.73±0.01,P<0.001).There was a significant correlation between HARI and Cystatin C(rs=0.531,P<0.001).The area of HARI index under the ROC curve was much higher than that of Cystatin C.The Child?Pugh staging phase was correlated with cystatin C levels(P=0.037).Conclusion The hepatic artery resistance index(HARI)is a more accurate parameter for patients with liver fibrosis than Cystatin C,and Cystatin C is a better indicator of cirrhosis.