血清胱抑素C检测对肝肾综合征的诊断价值被引量：10

Diagnostic value of cystatin C test in serum for the hepatorenal syndrome

导出

摘要目的探讨血清胱抑素C(Cys C)检测对肝肾综合征(HRS)的诊断价值。方法以24 h肌酐清除率(24 h-Ccr)为肾小球滤过率(GFR)标准,将63例晚期肝硬化患者分为两组:GFR<40 ml/min为HRS组,GFR≥40 ml/min为非HRS组。分别测定血清Cys C、血肌酐(Scr),并由MDRD(Modification of Diet in Renal Disease)公式估计肌酐清除率;结果Cys C、MDRD在HRS组与非HRS组(P均<0.01),Scr在HRS和非HRS组间无显著差异(P>0.05)。相关分析显示,Cys C与GFR的相关性最好(r=-0.628,P<0.01),Scr、MDRD与GFR无明显相关(r=-0.355,P>0.05;r=0.059,P>0.775)。ROC曲线表明,Cys C、Scr、MDRD中Cys C的诊断效率最高;结论Cys C是HRS患者良好的GFR标志物,其诊断HRS的能力优于Scr和MDRD。 Objective To investigate the diagnostic value of serum eystatin C （Cys C） test for the hepatorenal syndrome （HRS） ;Methods 63 patients with decompensated liver Cirrhosis were divided into 2 groups on the basis of their glomerular filuation rate （GFR）（24-hours ereatinine elearances, 24h-Cer）： HRS（GFR 〈 40 ml/min）and non HRS（GFR≥40 ml/min）. Cys C, Ser were measured respectively, and ereatinine clearances were calculated by Modification of Diet in Renal Disease formule（MDRD）. Results Cys C and MDRD were significant diffrence between HRS and non-HRS （all P 〈 0.01）. But Scr was not significant diffrence between HRS and non-HRS（ P 〉 0. 05）. Relationships with GFR, the best correlation of GFR （24h-Ccr） was found with Cys C （ r = - 0. 628, P 〈 0. 01）. However, no significant correlation was detected between GFR and Scr （ r = - 0. 355, P 〉 0. 05） and any significant correlation was not found between GFR and MDRD （ r = 0. 059, P 〉 0. 775）. ROC analysis showed that diagnostic accuracy of Cys C was the best in all analytes in hepatorenal syndrome patients; Conclusion Cys C was a good indicator of GFR in HRS patients. The diagnostic potential of cystatin C to detect patients with HRS was superior to that of Scr and MDRD.

作者王清平顾建文黄健伟

机构地区常州市第一人民医院检验科常州市武进三院肝病科

出处《中国实验诊断学》 2007年第12期1644-1646,共3页 Chinese Journal of Laboratory Diagnosis

关键词胱抑素C 肝肾综合征肾小球滤过率 cystatin C hepatorenal syndrome glomerular filtration rate

分类号 R575.2 [医药卫生—消化系统]

引文网络
相关文献

参考文献7

1Guido Filler, Arend Bokenkamp, W. Hofmann, et al. Cystatin C as a marker of GFR-history, indications, and future research[J]. Clinical Biochemistry, 2005,38 ( 1 ) : 1.
2中华医学会传染病与,寄生虫病学分会,肝病学分会.病毒性肝炎防治方案[J].中华肝脏病杂志,2000,8(6):324-329. 被引量：14017
3I Morard, G Mentha, L Spahr, et al. Long-term renal function after liver transplantation is related to calcineurin inhibltors blood levels[J]. Clin Transplant ,2006,20( 1 ) :96.
4J MacAulay, K Thompson, BA Kiberd, et al. Serum creatinine in patients with advanced liver disease is of limited value for identification of moderate renal dysfunction: are the equations for estimating renal function better? [J]. Can J Gastroenterol.2006,20(8) :521.
5Poggio ED, Wang X, Greene T, et al. Performance of the Modification of Diet in Renal Disease and Cockcroft-Gault equations in the estimation of GFR in health and in chronic kidney disease[J] .J Am Soc Nephrol, 2005,16:459.
6M Mussap and M Plebani. Biochemistry and clinical rote of human cystatin C[J] .Crit Rev Clin Lab Sci, 2004, 41(5-6):467.
7TA Gonwa L Jennings, ML Mai,et al. Estimation of glomerular filtration rates before and after orthotopic liver transplantation: evaluation of current equations[J]. Liver Transpl, 2004,10(2) : 301.