摘要
目的观察乙肝肝硬化低血钠症患者血清钠、肌酐以及胱抑素C与肾功能损害程度的关系。方法选择2017年1月~2019年12月我院收治的387例乙肝肝硬化低血钠症患者,通过肾小球滤过率(eGFR)评估患者肾功能,观察肾功能损害发生率,并分为肾功能损害组[eGFR<60 ml/(min·1.73)m^2]和肾功能正常组[eGFR≥60 ml/(min·1.73)m^2];比较两组血清钠、肌酐以及胱抑素C水平,观察三者与乙肝肝硬化患者肾功能损害严重程度的关系。结果共80例患者出现肾功能损害,肾功能损害发生率20.67%;肾功能损害组eGFR、Na+水平低于肾功能正常组,Scr和CysC水平高于肾功能正常组,差异有统计学意义(P<0.05);乙肝肝硬化低血钠患者eGFR与血清Na^+呈正相关(r=0.252,P<0.05),与Scr、CysC水平呈负相关(r=-0.284、-0.427,P<0.05);ROC曲线分析显示,血清Na^+水平诊断乙肝肝硬化低血钠患者肾功能损害的灵敏度、特异性为83.20%和72.90%,最佳截断值为126.47 mmol/L;Scr水平诊断乙肝肝硬化低血钠患者肾功能损害的灵敏度、特异性为83.80%和87.00%,最佳截断值值为113.28μmol/L,Cys-C水平诊断乙肝肝硬化低血钠患者肾功能损害的灵敏度、特异性为88.80%和85.80%,最佳截断值值为2.73 mg/L;三者联合诊断乙肝肝硬化低血钠患者肾功能损害的灵敏度、特异性为95.00%和97.90%。结论乙肝肝硬化低钠血症患者肾功能损害发生率较高,且与血清Na^+、Scr、CysC水平密切相关,三者均有较高的临床诊断价值,且三者联合检测可提高乙肝肝硬化低钠血症患者肾功能损害诊断的准确性和灵敏性。
Objective To observe the relationship between serum sodium,creatinine,cystatin C and the degree of renal damage in patients with hepatitis B liver cirrhosis and hyponatremia.Methods 387 patients with hepatitis B cirrhosis and hyponatremia admitted to our hospital from January 2017 to December 2019 were selected.The renal function of the patients was evaluated by the glomerular filtration rate(eGFR),and the incidence of renal damage was observed and divided Renal function impairment group[eGFR<60 ml/(min·1.73)m^2]and normal renal function group[eGFR≥60 ml/(min·1.73)m^2];compare the two groups'serum sodium,creatinine and cystatin C levels,observe the relationship between the three and the severity of renal damage in patients with hepatitis B and cirrhosis.Results A total of 80 patients had renal dysfunction,and the incidence of renal dysfunction was 20.67%;the eGFR and Na^+ levels of the renal dysfunction group were lower than those of the normal renal function group,and the levels of Scr and Cys-C were higher than those of the normal renal function group,the difference was statistically significant(P<0.05);eGFR in patients with hepatitis B liver cirrhosis and hyponatremia was positively correlated with serum Na^+(r=0.252,P<0.05),and negatively correlated with Scr and Cys-C levels(r=-0.284,-0.427,P<0.05);ROC curve analysis showed that the sensitivity and specificity of serum Na+level in diagnosing renal damage in patients with hepatitis B cirrhosis and hyponatremia were 83.20%and 72.90%,and the best cut-off value was 126.47 mmol/L;Scr level was used to diagnose patients with hepatitis B cirrhosis and hyponatremia.The sensitivity and specificity of renal impairment were 83.80%and 87.00%,and the best cut-off value was 113.28μmol/L.The sensitivity and specificity of Cys-C level in diagnosing renal impairment in patients with hepatitis B cirrhosis and hyponatremia were 88.80%and 85.80%,the best cut-off value was 2.73 mg/L;the sensitivity and specificity of the three combined diagnosis of renal damage in patients with hepatitis B cirrhosis and hyponatremia were 95.00%and 97.90%.Conclusion The incidence of renal dysfunction in patients with hepatitis B cirrhosis and hyponatremia was higher,and it was closely related to serum Na^+,Scr,and Cys-C levels.The three had high clinical diagnostic value,and the combined detection of the three could improve hepatitis B cirrhosis accuracy and sensitivity of the diagnosis of renal impairment in patients with hyponatremia.
作者
马燕
王晓忠
延国威
何倩
郭峰
王宏峰
MA Yan;WANG Xiao-zhong;YAN Guo-wei;HE Qian;GUO Feng;WANG Hong-feng(Department of Liver Diseases,the Affiliated Hospital of Traditional Chinese Medicine,Xinjiang Medical University,Urumqi 830000,Xinjiang,China)
出处
《医学信息》
2020年第19期55-58,共4页
Journal of Medical Information
基金
国家自然科学基金(编号:81760832)。
关键词
乙肝肝硬化
肾损害
低钠血症
肌酐
胱抑素C
Hepatitis B cirrhosis
Kidney damage
Hyponatremia
Creatinine
Cystatin C
