中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2013年
35期
21-22
,共2页
胱抑素 C%血肌酐%肝肾综合征%肌酐清除率
胱抑素 C%血肌酐%肝腎綜閤徵%肌酐清除率
광억소 C%혈기항%간신종합정%기항청제솔
Cystatin C%Serum creatinine%Hepatorenal syndrome%Creatinine clearance rate
目的：比较血清胱抑素 C（Cystatin C，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 值患者病死率以及不同结局的患者初始 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-C AUC 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。
目的：比較血清胱抑素 C（Cystatin C，cys-C）和血肌酐（Scr）在肝硬化失代償期腎損傷及疾病預後等方麵的診斷效能。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），設定臨界 Ccr 值，比較不同 Ccr 水平 Scr 及 Cys-c 的差彆，通過ROC 麯線分析比較兩項指標的診斷效能。隨訪12箇月，比較不同初始 Ccr 值患者病死率以及不同結跼的患者初始 CysC、Scr 值。結果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 麯線分析提示 Cys-C AUC 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。結論 CysC 能更準確的反映肝硬化患者腎小毬濾過功能，併且與患者預後有更高相關性，對肝硬化早期腎損害有較高診斷價值。
목적：비교혈청광억소 C（Cystatin C，cys-C）화혈기항（Scr）재간경화실대상기신손상급질병예후등방면적진단효능。방법선택간경화실대상기환자82례，측정 CysC、Scr 급기항청제솔（Ccr），설정림계 Ccr 치，비교불동 Ccr 수평 Scr 급 Cys-c 적차별，통과ROC 곡선분석비교량항지표적진단효능。수방12개월，비교불동초시 Ccr 치환자병사솔이급불동결국적환자초시 CysC、Scr 치。결과①이 Ccr ＜60mL/min 위림계치진행분조，A 조（Ccr ≥60mL/min）40례，B 조（Ccr ＜60mL/min）42례，량조초시혈기항치차이불현저，Cys-C 치 B 조현저고우 A 조，ROC 곡선분석제시 Cys-C AUC 치현저대우 Scr；②수방병례74례，전인사망18례，B 조병사솔현저고우 A 조。사망환자초시 Scr 급 Cys-C 균현저고우대조조。결론 CysC 능경준학적반영간경화환자신소구려과공능，병차여환자예후유경고상관성，대간경화조기신손해유교고진단개치。
Objective To compare serum Cys-C with Scr in the assessment of early kidney injury and prognosis for the decompensated cirrhotic patients. Method Recruit decompensated cirrhotic patients in ours hospital , examine their serum Cys-C with Scr and calculate the creatinine clearance rate.Define a critical value and compare the average serum Cys-C and Scr values in certain Ccr range.Follow up the cases for 12 months, compare the mortality between groups and their initial serum Cys-C and Scr value.Result ①82 cases were recruited, Ccr<60mL/min was defined as the critical value and the cases were grouped .Consequently group A (Ccr≥60mL/min)possess 40 cases and group B(Ccr<60mL/min)42 cases.Their initial Scr had no significant difference while the Cys-C value of group B was significantly higher than that of group A .For ROC curve analysis, Cys-C showed bigger AUC value than Scr; ②74 cases had finished the follow-up study while 18 cases died.The mortality of group B were higher than those of group A.Meanwhile, significantly higher Scr and Cys-C were shown in the case who were dead and the difference of Cys-C between the groups was especially obvious. Conclusion Serum Cys-C makes more accurate reflex of GFR for cirrhotic patients than Scr. It shows high relativity with the prognosis and high diagnostic value for the early kidney injury for cirrhotic patients.
