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慢性乙型肝炎患者血清胱抑素C与肾损伤的关系

Association between serum Cystatin C and renal injury in patients with chronic hepatitis B.

作者信息

Zheng Hui, Liu Haidong, Hao Anhua, Zhang Min, Wang Dexin

机构信息

Department of Clinical Laboratory, Qingdao Fifth People's Hospital.

Department of Gastroenterology, Qingdao Sixth People's Hospital.

出版信息

Medicine (Baltimore). 2020 Aug 7;99(32):e21551. doi: 10.1097/MD.0000000000021551.

Abstract

To explore the association between serum cystatin C (Cys-C) and renal damage in patients with chronic hepatitis B.We retrospectively analyzed the clinical data of 425 patients with chronic hepatitis B virus (HBV) infection. Liver stiffness measured by FibroScan was used to diagnosis liver fibrosis. Cys-C levels were detected via latex-enhanced immunoturbidimetric assay.A total of 425 patients were enrolled. Among them, 217 were patients with CHB with an eGFR > 90 mL/min/1.73 m and 208 with an eGFR ≤90 mL/min/1.73 m. Cys-C levels significantly differed in patients with eGFR > 90 mL/min/1.73 m compared with patients with eGFR ≤90 mL/min/1.73 m (0.81 ± 0.05 vs 1.05 ± 0.06 mg/L, P < .001). Moreover, the Cys-C levels were 0.82 ± 0.04 mg/L in patients without liver fibrosis, 0.98 ± 0.05 mg/L in patients with mild liver fibrosis, 1.05 ± 0.08 mg/L in patients with advanced liver fibrosis, and 1.12 ± 0.07 mg/L in patients with liver cirrhosis (P < .001). Multivariate analyses were conducted to explore the independent factors associated with a decreased eGFR. Multivariate analysis suggested that T2DM (P = .032), liver fibrosis (P = .013), and Cys-C level (P = .035) were the independent factors associated with the decreased eGFR in patients with CHB. While age (P = .020) and Cys-C level (P = .001) were the independent factors associated with the decreased eGFR in patients with CHB-related fibrosis.The fibrosis group had significantly higher Cys-C levels than those without fibrosis. Routine monitoring of Cys-C levels is of positive significance in preventing the development of renal impairment of CHB patients.

摘要

探讨慢性乙型肝炎患者血清胱抑素C(Cys-C)与肾损伤之间的关联。我们回顾性分析了425例慢性乙型肝炎病毒(HBV)感染患者的临床资料。采用FibroScan测量肝脏硬度来诊断肝纤维化。通过乳胶增强免疫比浊法检测Cys-C水平。共纳入425例患者。其中,217例为慢性乙型肝炎患者,估算肾小球滤过率(eGFR)>90 mL/min/1.73 m²,208例eGFR≤90 mL/min/1.73 m²。与eGFR≤90 mL/min/1.73 m²的患者相比,eGFR>90 mL/min/1.73 m²的患者Cys-C水平有显著差异(0.81±0.05 vs 1.05±0.06 mg/L,P<0.001)。此外,无肝纤维化患者的Cys-C水平为0.82±0.04 mg/L,轻度肝纤维化患者为0.98±0.05 mg/L,重度肝纤维化患者为1.05±0.08 mg/L,肝硬化患者为1.12±0.07 mg/L(P<0.001)。进行多因素分析以探讨与eGFR降低相关的独立因素。多因素分析表明,2型糖尿病(T2DM,P=0.032)、肝纤维化(P=0.013)和Cys-C水平(P=0.035)是慢性乙型肝炎患者eGFR降低的独立相关因素。而年龄(P=0.020)和Cys-C水平(P=0.001)是慢性乙型肝炎相关纤维化患者eGFR降低的独立相关因素。纤维化组的Cys-C水平显著高于无纤维化组。定期监测Cys-C水平对预防慢性乙型肝炎患者肾功能损害的发生具有积极意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c88f/7593051/afd758cb3902/medi-99-e21551-g002.jpg

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