Diagnostic Value Of Serum Cystatin C And Urotensin â…¡ In Detecting Hepatorenal Syndrome In Patients With Decompensated Liver Cirrhosis

Objective: To investigate the diagnositic value of serum cystatin C andurotensin Ⅱ in detecting hepatorenal syndrome in patients with livercirrhosis.Methods:50patients with liver cirrhosis were investigated and dividedinto Group1(single liver cirrhosis),Group2(subclinical hepatorenal syndrome)and Group3(hepatorenal syndrome).15healthy subjects were accepted ascontrols. To all the subjects, serum cystatin C, urotensin Ⅱ, plasma reninactivity(PRA), aldosterone (ALD)were measured. All data about serumcystatin C, urotensin Ⅱ, PRA and ALD were compared and correlationwere analysed respectively. The optimal diagnose threshold of subclinicalhepatorenal syndrome and hepatorenal syndrome in liver cirrhosis werecalculated by ROC curves.Results:1.As for serum cystatin C(cysC)(2.45±1.46mg/L versus1.03±0.20mg/L)，urotensin Ⅱ(uⅡ)(307.17±57.64pg/ml versus174.93±34.58pg/ml), PRA(5.74±3.48ng/ml/h versus3.85±1.27ng/ml/h), ALD(0.38±0.20ng/ml versus0.21±0.12ng/ml), there were significant differencesbetween cirrhotic group and normal group（P<0.05）.2.There were nosignificant differences with ALT,AST,TBA,ALB between single cirrhoticgroup, subclinical hepatorenal syndrome and hepatorenal syndrome（P＞0.05）, there was no significant difference with serum creatinine betweensingle cirrhotic group and subclinical hepatorenal syndrome（P＞0.05）.3. CysC,uⅡ,PRA,ALD of single cirrhotic group, subclinical hepatorenalsyndrome and hepatorenal syndrome were gradually heightened, there weresignificant differences （P<0.05）.4. CysC was positively correlated withPRA and ALD, correlation coefficient was0.74,0.68respectively. uⅡ waspositively correlated with PRA and ALD, correlation coefficient was0.68,0.65respectively.5. The area under ROC curves(AUC) of CysC and uⅡused to evaluate subclinical hepatorenal syndrome were0.91and0.867, theoptimal threshold of them were1.40mg/L and299.06pg/ml respectively. TheAUC of them used to evaluate hepatorenal syndrome were0.942and0.901,the optimal threshold of them were2.22mg/L and321pg/ml respectively.Conclusion:1. PRA and ALD level were obviously heightened insubclinical hepatorenal syndrome and hepatorenal syndrome indecompensated cirrhosis,and were positive proportion with kidney injury.As it indicated that they two participted generation and development ofhepatorenal syndrome.2. CysC and uⅡwere positively correlated withPRA and ALD，and they started to increase even in patients whose serumcreatinines were normal. It conduced to detect patients of subclinicalhepatorenal syndrome.3. AUC of CysC and uⅡ exceeded0.85in patientsof subclinical hepatorenal syndrome and hepatorenal syndrome withdecompensated hepatic cirrhosis. It indicated that CysC and uⅡ has somediagnosis value in subclinical hepatorenal syndrome and hepatorenalsyndrome in patients with liver cirrhosis.