血清胱抑素C与颈动脉狭窄程度的相关性研究

Correlation Between Serum Cystatin C and the Degree of Carotid Stenosis

目的探讨短暂性脑缺血发作或小卒中患者血清胱抑素C(Cys C)与颈动脉狭窄程度的关系。方法选择完成头颈部CT血管造影(CTA)检查的短暂性脑缺血发作或小卒中患者共计229例,分为颈动脉狭窄组127例(包括轻度狭窄组57例、中度狭窄组34例、重度狭窄组24例、闭塞组12例4个亚组)和非狭窄组102例。应用免疫比浊法测定血清Cys C水平,分析血清Cys C水平与颈动脉狭窄程度之间的相互关系。结果颈动脉狭窄组血清Cys C、同型半胱氨酸高于非狭窄组(P<0.01)。Spearman相关分析发现颈动脉狭窄与年龄、Cys C、同型半胱氨酸、尿酸、高血压、糖尿病呈正相关(P<0.05),Logistic回归分析显示血清Cys C并非颈动脉狭窄的独立危险因素,而年龄、高血压、糖尿病为颈动脉狭窄的独立危险因素。各亚组间分析发现,重度狭窄组Cys C水平较非狭窄组显著升高(P<0.05);重度狭窄组Cys C水平较轻度狭窄组、中度狭窄组升高,差异有统计学意义(P<0.01,P<0.05)。Logistic回归分析发现Cys C、甘油三酯、高血压为颈动脉重度狭窄的独立危险因素(P<0.05)。结论血清Cys C水平与颈动脉重度狭窄相关,为颈动脉重度狭窄的独立危险因素。

Aim The study was to investigate the correlation between serum cystatin C （Cys C） and the degree of carotid stenosis in patients with transient ischemia attack or minor stroke. Methods A total of 229 patients with transient ischemic attack （TIA） or minor stroke were collected, and each of them received head and neck computed tomo- graphy angiography （CTA） inspection. All of the patients were divided into two groups： group with carotid stenosis and group without carotid stenosis. The group with carotid stenosis included 127 subjects of patients, which is divided into 4 subgroups ： 44 subjects of mild carotid stenosis subgroup, 34 subjects of moderate carotid stenosis subgroup, 24 subjects of severe carotid stenosis subgroup, 12 subjects of oclussion subgroup; Another 102 patients without carotid stenosis were se- lected as the control group. The levels of serum Cys C were detected by immunoturbidimetric assay, and the correlation between serum Cys C and the degree of carotid stenosis was analyzed. Results Serum Cys C level and homocysteine level were higher in carotid stenosis group than in without carotid stnosis group （P 〈 0. 01 ）. On spearman correlation a- nalysis, carotid stenosis was correlated positively to age, serum Cys C, homocysteine （Hcy）, uric acid （UA）, hyperten- sion and diabetes mellitus （ P 〈 0.05 ） ; The Logistic regression analysis showed that Cys C was not the independent risk factor for carotid stenosis. After the subjects of carotid stenosis group were divided into 4 subgroups according to the se- verity of carotid stenosis, serum Cys C levels were higher in severe carotid stenosis group than in without carotid stenosis group （P 〈 0. 05） ; The Cys C level of severe stenosis group was statistically and significantly different from mild stenosis group and moderate stenosis group （P 〈 0. 01, P 〈 0. 05）. The Logistic regression analysis showed that Cys C, triglycer- ide （ TG）, hypertension were the independent risk factors for carotid with severe stenosis. Conclusion Serum Cys C level was positively correlated with carotid artery with severe stenosis in patients with transient ischemic attack or minorstroke, and was an independent risk factor for carotid artery with severe stenosis.