Objective To investigate the clinical value of serum Cystatin C (Cys C) for monitoring of renal function in patient after liver resection. Methods 24-hours creatinine clearance (CCr), serum level of Cys C and serum creatinine (SCr) were measured in 141 patients after liver resection. x2 test. Pearson correlation test and ROC curve were utilized to evaluate the diagnostic significance of Cys C. Results Thirty-two out of 141 patients suffered the renal injury. Among these 32 patients, level of Cys C increased in 28 cases, whereas the elevation of SCr level in 15 cases were turn out. Cys C and SCr both significantly inversely correlated with CCr (CysC: r=-0.742, P＜0.001; SCr: r=-0.503, P＜0.001). However, coefficient of Cyst C to CCr was obviously higher than that of SCr. Moreover, using ROC curve, Cystatin C was diagnostically superior to SCr (area under the curve [AUC] for cystatin C 0.815. AUC for creatinine 0.643). Conclusion Cys C is a more accurate marker of renal injury in patients after liver resection. Deter:tion of Cvs C level in these patients can contrihute the prevention of renal injury or hepatorenal syndrome.%目的 探讨血清半胱氨酸蛋白酶抑制剂C(Cystatin C,Cys C)监测对肝脏手术后患者肾功能水平的临床价值.方法 测定141例肝脏手术患者术后的24 h 肌酐清除率(24 hccr)、血清肌酐(SCr)以及血清Cystatin C(Cys C)水平,并以CCr<80 mL/min/1.73 m2 作为肾功能损害诊断标准,采用χ2检验、相关性分析和ROC 曲线分析了解Cys C 的诊断价值.结果 141 例患者中共有32 例出现CCr 下降,在这32 例患者中,CysC 水平上升的有28 例,而SCr 出现异常的仅有15 例,χ2检验分析后提示CysC 对CCr 的评估效能优于SCr(P<0.05).相关性分析提示在该类患者中,Cys C 与SCr 均和CCr 有着显著的负相关性(CysC:r=-0.742,P<0.001;SCr:r=-0.503,P<0.001),而Cys C 的相关系数较高.ROC 曲线分析显示Cys C 的曲线下面积(AUC)值明显高于SCr(0.815 vs 0.643).结论 Cys C 较SCr 能更为准确反映肝脏手术患者术后的肾功能损害,常规监测该类患者的Cys C 水平,对有效预防该类患者术后肾功能不全,减少肝肾综合征的发生率具有积极意义.
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