四川医学Issue(9)：1232-1236,5.DOI:10.16252/j.cnki.issn1004-0501-2015.09.008
胱抑素C及其eGFR方程在诊断肝硬化患者肾损害中的应用
Clinical Application of Cystatin C and It’s eGFR Equation for Diagnosing Kidney Impairment in Patients with Cir-rhosis
摘要
Abstract
Objective To investigate the diagnostic efficiency of Cystatin C( CysC) level and it’s eGFR equation for early diagnosis of kidney impairment in patients with cirrhosis. Methods Total 465 patients admitted to Mianyang Central Hospital and Sichuan Orthopeadic Hospital between August 2012 to December 2014 were enrolled in this study. Serum creatinine( SCr) and Cy-sC level were determined, and estimated glomerular filtration rate( eGFR) was calculated by CysC concentration. All cirrhosis pa-tients were classified by the Child-Pugh classification, then the diagnosis performances of SCr, CysC and eGFR were analyzed by ROC curve. Results The optimal cut-off values of serum eGFR, CysC and SCr( male or female) for diagnosing kidney impairment in patients with cirrhosis were 63. 4 ml/min/1. 73 m 2 and 1. 24 mg/L and 76. 8μmol/L( male) or 62. 6μmol/L( female) , respec-tively. There was statistically significant between AUC eGFR ( it represented the area under the curve for eGFR) or AUC CysC and AUCSCr(both P<0. 001). Furthermore, when used to the optimal cut-off values and the reference limit separately to analyze the performance of SCr, CysC and eGFR for diagnosing kidney impairment in patients with cirrhosis and various subgroups by Child-Pugh classifications, the results showed that only eGFR had similar sensitivity, misdiagnosis rate and consistency ( P >0. 05 ) . Conclusion eGFR is a better marker than CysC and SCr for diagnosing secondary kidney impairment in patients with cir-rhosis, which can early reflect the change of GFR. It should be used as an index for monitoring kidney function injure in patients with cirrhosis. However, we suggest that each clinical laboratory should establish its own optimal cut-off values.关键词
肝硬化/肾功能损害/估计肾小球滤过率/胱抑素C/肌酐Key words
cirrhosis/kidney damage/estimated glomerular filtration rate/cystatin c/creatinine分类
医药卫生引用本文复制引用
黄玉霞,杨渝伟,邹明,池继敏,俸家富..胱抑素C及其eGFR方程在诊断肝硬化患者肾损害中的应用[J].四川医学,2015,(9):1232-1236,5.基金项目
四川省卫生厅科学研究基金(原)(编号:020089) （原）
四川省卫生计生委科研课题(编号:150175) （编号:150175）
