胱抑素C对病毒性肝炎患者早期肾损伤的诊断价值

朱娅鸽; 王静; 刘锦锋; 何英利

doi:10.3969/j.issn.1001-5256.2019.11.013

胱抑素C对病毒性肝炎患者早期肾损伤的诊断价值

DOI: 10.3969/j.issn.1001-5256.2019.11.013

1. 西安交通大学第一附属医院感染科
2. 西安交通大学第一附属医院风湿免疫科

基金项目:

国家自然科学基金(81770622)；陕西省创新能力支撑计划(2018KRM092)；

详细信息

中图分类号: R512.6;R692
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出版历程
- 收稿日期: 2019-06-05
- 出版日期: 2019-11-20

Value of cystatin C in the diagnosis of early renal injury in patients with viral hepatitis

Department of Infectious Diseases,The First Affiliated Hospital of Xi'an Jiaotong University

Research funding:

摘要

摘要: 目的探讨血清胱抑素C（Cys C）检测在病毒性肝炎早期肾损伤诊断中的意义。方法回顾性分析2018年1月1日-2018年12月31日西安交通大学第一附属医院270例慢性HBV感染及HCV感染者临床资料,按FibroScan检测的肝纤维化程度分为4组:无明显肝纤维化组（F0～F2）、明显肝纤维化组（F2～F3）、进展性肝纤维化组（F3～F4）、肝硬化组（> F4）,比较各组尿素氮、肌酐、Cys C及估算的肾小球滤过率（eGFR）水平差异。计量资料2组间比较采用t检验;多组间比较采用单因素方差分析,进一步两两比较采用LSD-t检验。相关性检验使用Pearson相关分析。结果 270例患者中,HBV感染者200例,HCV感染者70例。eGFR及Cys C水平在4组中差异均有统计学意义（F值分别为2. 714、3. 081,P值分别为0. 032、0. 017）。进一步两两比较,肝硬化组的eGFR低于无明显纤维化组[（99. 61±6. 92） ml·min-1·1. 73 m-2vs （105. 32±1. 86） ml·min-1<...
- 乙型肝炎,慢性 /
- 丙型肝炎,慢性 /
- 肝硬化 /
- 肾损伤
Abstract: Objective To investigate the value of serum cystatin C( Cys C) in the diagnosis of early renal injury in patients with viral hepatitis. Methods A retrospective analysis was performed for the clinical data of 270 patients with chronic hepatitis B virus( HBV) or hepatitis C virus( HCV) infection. According to the fibrosis degree determined by FibroScan,the patients were divided into non-significant liver fibrosis group( F0-F2),significant liver fibrosis group( F2-F3),progressive liver fibrosis group( F3-F4),and liver cirrhosis group( >F4). The four groups were compared in terms of urea nitrogen,creatinine,Cys C,and estimated glomerular filtration rate( e GFR). The t-test was used for comparison of continuous data between two groups; a one-way analysis of variance was used for comparison between multiple groups,and the least significant difference t-test was used for further comparison between two groups. A Pearson correlation analysis was used to investigate correlation. Results Among the 270 patients,200 had HBV infection and 70 had chronic HCV infection. There were significant differences in e GFR and Cys C between the four groups( F = 2. 714 and 3. 081,P = 0. 032 and 0. 017). Further comparison between two groups showed that the liver cirrhosis group had a significantly lower eGFR than the non-significant liver fibrosis group( 99. 61 ± 6. 92 ml·min-1·1. 73 m-2 vs 105. 32 ± 1. 86 ml·min-1·1. 73 m-2,t = 2. 655,P = 0. 008); compared with the non-significant liver fibrosis group,the other three groups had significant increases in the serum level of Cys C( significant liver fibrosis group: 1. 01 ± 0. 08 mg/L vs 0. 84± 0. 03 mg/L,t =-2. 218,P = 0. 028; progressive liver fibrosis group: 1. 02 ± 0. 04 mg/L vs 0. 84 ± 0. 03 mg/L,t =-4. 218,P < 0. 001;liver cirrhosis group: 1. 07 ± 0. 05 mg/L vs 0. 84 ± 0. 03 mg/L,t =-4. 675,P < 0. 001). For the patients with HBV or HCV infection,the patients with liver cirrhosis had a significantly higher serum level of Cys C than those without significant liver fibrosis( patients with HBV infection: 1. 06 ± 0. 36 mg/L vs 0. 84 ± 0. 13 mg/L,t =-3. 192,P = 0. 003; patients with HCV infection: 1. 04 ± 0. 22 mg/L vs 0. 86 ± 0.15 mg/L,t =-2. 318,P = 0. 029). Liver stiffness measurement was positively correlated with the serum level of Cys C( r = 0. 247,P = 0.003),while there was no correlation between liver stiffness measurement and eGFR( r =-0. 002,P = 0. 975). Conclusion Cys C can be used for the diagnosis of early renal injury in patients with viral hepatitis,and regular monitoring of Cys C level has a positive significance in the prevention and treatment of hepatorenal syndrome in such patients.
- hepatitis B,chronic /
- hepatitis C,chronic /
- liver cirrhosis /
- kidney injury

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参考文献(9)

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