【摘要】 目的建立血清半胱氨酸蛋白酶抑制物C(CystatinC,CysC)的定量ELISA检测方法,探讨血清CysC水平在肝肾综合征(HRS)早期诊断中的价值。方法用ELISA法测定81例常规检查肾功能正常的肝硬化患者和26例健康体检者的血清CysC水平,同时检测其血肌酐(Scr)、尿素氮(BUN)及尿肌酐(Ucr),算出校正24h肌酐清除率(Ccr)作为肾小球滤过率标准,40≤Ccr<80ml·min-1·1.73m-2的肝硬化患者被列为亚临床HRS组。结果亚临床HRS组血清CysC浓度明显高于单纯肝硬化组(P<0.05);而Scr、BUN在两组的差别无统计学意义。CysC与Ccr相关性比Scr与Ccr相关性好(r=-0.91对r=-0.72,P<0.05);受试者工作特征曲线(ROC)分析显示CysC曲线优于Scr。结论血清CysC较Scr、BUN能更敏感地检测出肝硬化患者的轻度肾功能损害,可作为识别亚临床HRS的一项新指标。更多还原

【Abstract】 Objective To set up a new quantitative determination method of assaying serum cystatin C(Cys C) concentration by means of Enzyme-linked immunoadsordent assay (ELISA), and to investigate the diagnostic value of serum Cys C as a marker of detecting subclinical hepatorenal syndrome (HRS) in patients with liver cirrhosis. Methods 81 patients with liver cirrhosis were divided into Group 1 [creatitnine clearance (Ccr)≥80 ml·min~ -1 ·1.73 m~ -2 , n=43] and Group 2-subclinical HRS group (40≤Ccr<80 ml·min~ -1 ·1.73 m~ -2 , n=38). Serum Cys C, Serum creatinine (Scr) and BUN of them were assayed and compared with those of 26 healthy subjects as controls. Serum Cys C was measured by ELISA. Results Serum Cys C concentration was significantly higher in patients with liver cirrhosis than that in control group [(3.15±1.43) mg/L vs (2.08±0.10) mg/L, P< 0.01], and its levels in Group 2 was also significantly higher than that in Group 1 [(3.56±2.01) mg/L vs (2.78±0.78) mg/L, P<0.05)], while there were no significant difference in Scr and BUN between two groups. The correlation of Cys C with Ccr was stronger than Scr with Ccr (r=-0.91 vs r=-0.72, P<0.05). Receiver-operating characteristics (ROC) analysis showed that the ROC curve was significantly better for Cys C than that for Scr. Conclusion Serum Cys C detection could detect slight renal dysfunction in cirrhotic patients with subclinical HRS, and may be more sensitive than Scr and BUN.更多还原