比较血清胱抑素c及肌酐对肝肾综合征的诊断价值

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1、国睚

2、匿—盈同2013年12月第11卷第35期·论著·21比较血清胱抑素C及肌酐对肝肾综合征的诊断价值。曾贵林谭妙玲(广东省江门市新会区人民医院，广东江门529100)【摘要】目的比较血清胱抑素C(CystatinC，cys—C)和血肌酐(Scr)在肝硬化失代偿期肾损伤及疾病预后等方面的诊断效能。方法选择肝硬化失代偿期患者82例，测定CysC、Scr及肌酐清除率(Ccr)，设定临界Ccr值，比较不同Ccr水平Scr及Cys—c的差别，通过ROC曲线分析比较两项指标的诊断效能。随访12个月，比较不同初始Ccr

3、值患者病死率以及不同结局的惠者初始CysC、Scr值。结果①以Ccr<60mL／min为临界值进行分组，A组(Ccr≥60mL／min)40例，B组(Ccr<60mL／min)42例，两组初始血肌酐值差异不显著，Cys—C值B组显著高于A组，ROC曲线分析提示Cys—CAUC值显著大于Scr；②随访病例74例，全因死亡18例，B组病死率显著高于A组。死亡患者初始Scr及Cys—C均显著高于对照组。结论CysC能更准确的反映肝硬化患者肾小球滤过功能，并且与患者预后有更高相关性，对肝硬化早期肾损害有较高诊断价值

4、。【关键词】胱抑素c；血肌酐；肝肾综合征；肌酐清除率中图分类号：R575文献标识码：B文章编号：1671—8194(2013)35-0021-02ATrialtoCompareSerumCys——CwithSerumCreatinineintheDiagnosisofHepatorenalSyndromeZENGGui—lin．1NMino—ling(XinhuiDistrictPeople'shospitalJiangmen52910~China)【Abstractl0bjecfiveTocompares

5、erumCys—CwithScrintheassessmentofearlykidneyinjuryandprognosisforthedecompensatedcirrhoticpatients．MethodRecmitdecompensatedcirrhoticpatientsinourshospital，examinetheirsemmCys—CwithScrandcalculatethecreatinineclearancerate．Defineacriticalvalueandcomparethe

6、averageserumCys—CandScrvaluesincertainCcrrange．Followupthecasesfor12months，comparethemortalitybetweengroupsandtheirinitialserulnCys—CandScrvalue．Result①82caseswererecmited，Ccr<60mL／minwasdefinedasthecriticalvalueandthecasesweregrouped．ConsequentlygroupA(Cc

7、rt>60mL／min)possess40casesandgroupB(Ccl<60mL／min)42cases．TheirinitialScrhadnosignificantdifferencewhiletheCys—CvalueofgroupBwassignificantlyhigherthanthatofgroupA．ForROCcurveanalysis．Cys—CshowedbiggerAUCvaluethanScr；②74caseshadfinishedthefollow—upstudywhil

8、el8casesdied．ThemortalityofgroupBwerehigherthanthoseofgroupA．Meanwhile，significantlyhigherScrandCys—CwereshowninthecasewhoweredeadandthediferenceofCys—Cbetweenthegroupswasespeciallyobvious．ConclusionSemmCys—CmakesmoreaccuratereflexofGFRforcirhoticpatientst

9、hanScr．Itshowshighrelativitywiththeprognosisandhighdiagnosticvaluefortheearlykidneyinjuryforcirhoticpatients．【Keywords】CystatinC；Serumcreatinine；Hepatorenalsyndrome；CreatinineclearancerateHRS是晚期肝病患者出现以肾功能损伤、肾