缺血性脑卒中患者胱抑素C与颈动脉粥样硬化的关系

Relation between cystatin C and carotid atherosclerosis in ischemic stroke patients

目的探讨急性缺血性脑卒中患者血清胱抑素C与颈动脉粥样硬化(carotid atherosclerosis,CAS)的关系。方法选择急性缺血性脑卒中患者92例,根据颈动脉彩色超声结果分为CAS组67例和非CAS组25例。CAS组根据CAS的严重程度分为:轻度CAS 46例、中度CAS 15例和重度CAS 6例;根据超声检查分为:硬斑块26例、软斑块16例和混合斑块25例;根据颈动脉受累范围分为:单侧斑块33例和双侧斑块34例。分析组间胱抑素C水平与颈动脉斑块严重程度、斑块性质及受累范围间的相关性。结果 CAS组胱抑素C水平明显高于非CAS组,差异有统计学意义(P<0.05)。logistic回归分析,胱抑素C水平升高是CAS形成的独立预测因素(P<0.01)。中度和重度CAS患者胱抑素C水平明显高于轻度CAS患者(P<0.01)。Spearman等级相关分析,CAS严重程度与胱抑素C水平呈正相关(r=0.246,P<0.05)。结论胱抑素C水平的升高能预测CAS的发生,并能评估CAS的严重程度,但尚不能作为评估颈动脉粥样硬化斑块稳定性及受累范围的可靠指标。

Objective To study the relation between serum cystatin C level and carotid atheroscle- rosis （CAS） in acute ischemic stroke （AIS） patients. Methods Ninety-two AIS patients were di- vided into CAS group （n=67） and non-CAS group （n=25） according to their carotid color ultra- sonographic findings. Patients in CAS group were further divided into mild CAS group （n=46）, moderate CAS group （n= 15）, severe CAS group （n= 6） according to the severity of CAS,into hard plaque group （n=26）,soft plaque group （n=16）,mixed plaque group （n=25） aaccording to the findings of ultrasonography,and into unilateral plaque group （n= 33） and bilateral plaque group （n=34） according to the involved carotid artery. Relation of serum eystatin C level with se- verity of CAS,nature of plaque and involved carotid artery was analyzed. Results The serum cys- tatin C level was significantly higher in CAS group than in non-CAS group （P〈.05）. Logistic regression analysis showed that elevated serum cystatin C level was an independent predictor for CAS. The serum cystatin C level was significantly higher in moderate CAS group and severe CAS group than in mild CAS group （P〈0. 01）. Spearman rank correlation analysis revealed that the severity of CAS was positively related with the serum cystatin C level （r=0. 246 ,P〈0.05）. Con- clusion Elevated serum cystatin C level can predict the occurrence of CAS and assess its severi- ty,but is not a reliable indicator for the stability and involvement of carotid artery plaques.