Cys-C在急性脑梗死并发SIRS致MODS患者中的水平变化

Changes of Cys-C in acute cerebral infarction leading to systemic inflammatory response syndrome which causes multiple organ dysfunction syndrome

目的观察胱抑素-C(Cystatin-C,Cys-C)在急性脑梗死(acute cerebral infarction,ACI)并发全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)致多器官功能障碍综合征(multiple organdysfunction syndrome,MODS)患者中的水平变化。方法 ACI患者278例根据其并发SIRS、MODS情况分为3组:SACI组166例、SIRS组47例、MODS组65例。同时,收集健康体检者50例作为正常对照组。采用免疫比浊法(PETIA)测定血清Cys-C水平,观察其与超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、脂蛋白a(Lipoprotein a,LPa)的相关性。结果与对照组比较,观察组各组血清Cys-C、LPa、hs-CRP水平均明显升高(P<0.01),组间比较,SIRS、MODS组患者升高更为明显,以MODS组更为突出(P<0.05或P<0.01)。相关性分析表明,血清Cys-C水平与hsCRP、LPa呈正相关。结论 Cys-C与炎症反应关系密切,参与了ACI并发SIRS、MODS,并具有重要作用。

Objective To observe changes of Cys-C in acute cerebral infarction （ACI） leading to systemic inflam- matory response syndrome （SIRS） which causes multiple organ dysfunction syndrome （MODS）. Methods 278 cases of ACI were divided into three groups：166 cases were simple ACI （SACI group） ,47 cases were ACI companied with SIRS （SIRS group） ,65 cases were ACI companied with MODS （MODS group）. 50 cases were normal control group. PETIA method was used to measure the serum Cys-C levels. To analyze the correlation between the serum Cys-C levels and hypersensitive C-reactive protein （hs-CRP）and Lipoprotein-a （LPa） levels. Results The serum Cys-C,hs-CRP and LPa levels in patients with SACI ,SIRS and MODS increased significantly comparing to those in patients of the normal control group（ P 〈0.01 ）. The serum Cys-C, LPa and hs-CRP levels in patients with MODS were significantly higher than those in patients with SACI, SIRS （P 〈 0.05 or P 〈 0.01 ）. Results of the correlation analysis showed that the serum Cys-C levels were posi- tively correlated to the serum LPa and hs-CRP levels. Conclusions Cys-C is closely related to inflammation, might play significant role in ACI leading to SIRS which causes MODS.