【摘要】 目的探讨血清半胱氨酸蛋白酶抑制剂C(Cys C)对肝硬化患者肾功能早期损害的诊断价值。方法测定67例肝硬化患者和32名健康对照者的血清肌酐(Cr)、尿素(Urea)、肌酐清除率(Ccr)和Cys C水平,并将患者按性别、Ch ild-Pugh分级或Ccr水平进行分组评价。结果肝硬化患者血清Ccr和Cys C水平与对照组比较差异有显著性(P<0.001),但Cr和Urea差异无显著性。不同性别患者Ccr、Cr和Cys C水平与对照组比较差异有显著性(P<0.05~0.001),但Urea无差异。肝硬化患者Ch ild-Pugh分级各亚组Ccr、Cr、Urea和Cys C水平与健康对照组比较差异有显著性(P<0.05~0.001)。以Ccr 70 m l/m in为界点将患者分为Ⅰ和Ⅱ亚组,并与对照组比较,结果表明仅Cys C水平差异有显著性(P<0.001),Cys C水平Ⅰ和Ⅱ2亚组间差异也有显著性(P<0.001)。受试者工作特征曲线(ROC曲线)显示Cys C诊断有效性优于Cr和Urea。结论血清Cr和Urea难以对肝硬化患者肾功能轻度受损进行诊断,Ccr虽能作出早期指示,却过高估计试验结果,而Cys C能较准确地作出早期检测,提示其可能是潜在的肝硬化患者肾功能早期损害的指标。更多还原

【Abstract】 Objective To investigate the diagnostic value of serum cystatin C(Cys C) for the detection of early impaired renal function in patients with liver cirrhosis. Methods The levels of serum creatinine(Cr),urea,creatinine clearance(Ccr),and Cys C in 67 patients with liver cirrhosis(patients divided group by sex,Child-Pugh scores or Ccr levels) and 32 healthy controls were mearsured. Results The levels of serum Ccr and Cys C in patients with liver cirrhosis were significantly different than in healthy controls(P<(0.001)),but Cr and urea were not significantly different.The levels of serum Ccr,Cr,Cys C in patient with liver cirrhosis of different sex were significantly different than control group(P<(0.05)～(0.001)),but urea was not significantly different.As patients with liver cirrhosis were divided into 3 groups by Child-Pugh scores,the levels of serum Ccr,Cr,urea and Cys C were significantly different than those in control group(P<(0.05)～(0.001)).As patients with liver cirrhosis were divided into group Ⅰ and Ⅱ by Ccr=70 ml/min,the level of serum Cys C was higher than that in healthy control,and Cys C was higher in group Ⅱ than that in group Ⅰ(P<(0.001)).Receiver operator characteristics(ROC) revealed a clear advantage of Cys C over Cr and urea. Conclusions Cr and urea cannot detect the moderately impaired renal function in patients with liver cirrhosis.Ccr was a early marker,but it overestimates diseases.Cys C can give an accurate diagnosis.Therefore,serum Cys C may be a potential marker for detection of early impaired renal function in patients with liver cirrhosis.更多还原