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1、國睚
2、匿—盈同2013年12月第11卷第35期·論著·21比較血清胱抑素C及肌酐對肝腎綜合征的診斷價值。曾貴林譚妙玲(廣東省江門市新會區(qū)人民醫(yī)院，廣東江門529100)【摘要】目的比較血清胱抑素C(CystatinC，cys—C)和血肌酐(Scr)在肝硬化失代償期腎損傷及疾病預后等方面的診斷效能。方法選擇肝硬化失代償期患者82例，測定CysC、Scr及肌酐清除率(Ccr)，設(shè)定臨界Ccr值，比較不同Ccr水平Scr及Cys—c的差別，通過ROC曲線分析比較兩項指標的診斷效能。隨訪12個月，比較不同初始Ccr
3、值患者病死率以及不同結(jié)局的惠者初始CysC、Scr值。結(jié)果①以Ccr<60mL／min為臨界值進行分組，A組(Ccr≥60mL／min)40例，B組(Ccr<60mL／min)42例，兩組初始血肌酐值差異不顯著，Cys—C值B組顯著高于A組，ROC曲線分析提示Cys—CAUC值顯著大于Scr；②隨訪病例74例，全因死亡18例，B組病死率顯著高于A組。死亡患者初始Scr及Cys—C均顯著高于對照組。結(jié)論CysC能更準確的反映肝硬化患者腎小球濾過功能，并且與患者預后有更高相關(guān)性，對肝硬化早期腎損害有較高診斷價值
4、。【關(guān)鍵詞】胱抑素c；血肌酐；肝腎綜合征；肌酐清除率中圖分類號：R575文獻標識碼：B文章編號：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是晚期肝病患者出現(xiàn)以腎功能損傷、腎
