Evaluation of serum cystatin C concentration as a marker of renal function in patients with cirrhosis of the liver
Evaluation of serum cystatin C concentration as a marker of renal function in patients with cirrhosis of the liver
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DOI：
10.1136/gut.50.1.106
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发表时间：
2002-01-01
期刊：
影响因子：
24.5
通讯作者：
Vogeser, M
中科院分区：
文献类型：
--
作者：
Gerbes, AL;Gülberg, V;Vogeser, M
背景和目标。诊断中度肾功能受损对肝硬变患者尤为重要。虽然肾小球滤过率明显受损的患者很容易通过血清肌酐浓度升高来诊断，但这一常规参数可能会漏掉中度肾功能减退。最近，胱抑素C已被认为是肾功能的敏感标志物，不受性别或肌肉质量的影响。方法：对97例内生性肝硬变患者的血清半胱氨酸氨基转移酶C(Cystatin C)浓度进行研究，将患者分为肌酐清除量大于或等于70ml/m in组(n=55)和肌酐清除量40~69m l/m in组(n=42)。结果：血清胱抑素C浓度(SD)为1.31(0.51v1.04)mg/L(p=0.008)。2组尿素浓度(1.03(0.52)vs0.86(0.22)mg/100ml(p=0.03))高于I组(p=0.03)，尿素浓度差异无统计学意义。受试者-操作者特征(ROC)显示，半胱氨酸氨基转移酶C的鉴别诊断优势优于肌酐和尿素。以1.0 mg/L、0.9 mg/100ml和28 mg/100ml为界值时，胱抑素C、肌酐和尿素的敏感性分别为69%、45%和44%(P<0.05)。
Background and aims. Diagnosis of moderately impaired renal function is, of particular importance in patients with cirrhosis of the liver. Whereas patients with a markedly impaired glomerular filtration rate can be diagnosed easily by elevated serum creatinine concentrations, moderately reduced renal function may be missed by this conventional parameter. Recently, cystatin C has been suggested as a sensitive marker of renal function, independent of sex or muscle mass. Therefore, the aim of this study was to investigate the value of serum cystatin C concentration for the detection of moderately impaired renal function.Methods: Ninety seven inhospital patients with cirrhosis and a 24 hour creatinine clearance of at least 40 ml/min were investigated and divided into group 1 (creatinine clearance greater than or equal to 70 ml/min; n=55) and group 2 (creatinine clearance 40-69 ml/min; n=42).Results: Serum cystatin C concentrations (mean (SD): 1.31 (0.51) v 1.04 (0.34) mg/l (p=0.008)) and creatinine. concentrations (1.03 (0.52) v 0.86 (0.22) mg/100 ml (p=0.03)) were higher in group 2 than in group I; there was no significant difference in urea concentrations. Receiver-operator characteristics (ROC) revealed a differential diagnostic advantage of cystatin C over creatinine and urea. At cut off concentrations of 1.0 mg/l, 0.9 mg/100 ml, and 28 mg/100 ml, respectively, cystatin C, creatinine, and urea exhibited 69%, 45%, and 44% sensitivity (p