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目的探讨肝硬化病人进行肾小球滤过率评估时,血清胱抑素C(Cystatin C,CysC)浓度测定的应用价值。方法本院确诊的肝硬化患者45例,分别测定其血清胱抑素C浓度、血肌酐(Scr)浓度,并用Cockcroft-Gault(CG)公式计算出内生肌酐清除率(Ccr),并以此作为评估肾小球滤过率(GFR)的标准。结果Scr浓度测定肾小球滤过率下降的病人有12人,占总数的26.67%,CG计算结果测定肾小球滤过率下降的病人为24人,占总人数的53.33%,测定CysC浓度测出肾小球滤过率下降的病人有37人,占总人数的82.22%,显著高于前两种方法,差异有统计学意义(P<0.05);CysC对于患者肾功能受损的诊断准确性也显著高于Scr和CG。结论CysC浓度测定简便、实用,是一种敏感的评估肝硬化患者GFR的标志物,而Scr、CG的临床实用价值不大。
Objective To investigate the value of serum cystatin C (CysC) in the assessment of glomerular filtration rate in patients with liver cirrhosis. Methods Forty-five patients with cirrhosis diagnosed in our hospital were enrolled in this study. Serum cystatin C concentration and serum creatinine (Scr) concentrations were measured. The creatinine clearance rate (Ccr) was calculated by Cockcroft-Gault (CG) As a criterion for assessing glomerular filtration rate (GFR). Results Scr concentration determination of glomerular filtration rate decreased in 12 patients, accounting for 26.67% of the total, CG calculated results glomerular filtration rate decreased in patients was 24, accounting for 53.33% of the total number of determination of CysC concentration 37 patients with glomerular filtration rate decreased, accounting for 82.22% of the total number, significantly higher than the former two methods, the difference was statistically significant (P <0.05); CysC for the diagnosis of renal impairment The accuracy is also significantly higher than Scr and CG. Conclusion CysC concentration is a simple and practical method to detect GFR in patients with cirrhosis. However, the clinical value of Scr and CG is not significant.