急性脑梗死患者血清胱抑素C和β2-微球蛋白水平的临床观察

Clinical Observation of Serum Cyst-C and β2-MG in Patients with Acute Cerebral Infarction

目的观察急性脑梗死患者血清胱抑素C(cystatin C和Cyst-C)和β2-微球蛋白(β2-microglobulin,β2-MG)变化与脑梗死TOAST分型之间的关系。方法选取急性脑梗死患者115例为病例组,按照TOAST分型标准分为大动脉粥样硬化性脑梗死型(LAA)、心源性栓塞型(CE)、小动脉闭塞性脑梗死型(SAO)、其他原因所致脑梗死型(OC)、不明原因性脑梗死型(UND),健康体检者50例为对照组,测定两组血清Cyst-C和β2-MG浓度,并分析其在两组之间、病例组各亚型之间差异。结果病例组血清Cyst-C、β2-MG明显高于对照组,差异有统计学意义(P<0.05),经Logistic线性回归分析发现,血清Cyst-C与脑梗死相关(P<0.05)。LAA型、CE型、SAO型血清Cyst-C较对照组明显升高,其中CE型升高最明显,差异有统计学意义(P<0.05),OC及UND型因病例数较少未作分析。LAA型、CE型、SAO型之间β2-MG差异无显著性(P>0.05)。Logistic线性回归分析发现血清Cyst-C水平与LAA型、CE型、SAO型均相关,且与CE型相关性最强(OR=8.98;95%CI 2.072-38.921)。结论血清Cyst-C、β2-MG的变化可能是脑梗死的危险因素。血清Cyst-C在不同亚型脑梗死中浓度不同,在CE型升高最明显,对脑梗死的病因具有一定的提示作用。

Aim To observe the level of the serum cystatin C and β2-microglobulin of acute cerebral infarction patients and its relationship with different subtypes by the Trial of Org10172 in Acute Stroke Treatment（ TOAST）.Methods The investment contains 115 acute cerebral infarction patients and 50 controls,and the patients were classified into five subtypes according to TOAST creteria.Recorded the serum Cyst-C and β2-MG level and analyzed the difference between the two groups and their TOAST subtypes.Results The serum Cyst-C and β2-MG of the patients was significantly higher than the controls（ P〈0.05）.Logistic linear regression analysis showed that serum level of Cyst-C had significant correlation（ P〈0.05）.The serum Cyst-C of the subtypes was significantly higher compared to the controls,and the level of Cyst-C in the CE was the highest（ P〈0.05）.There was no difference among each subtypes of the serumβ2-MG.Logistic linear regression analysis showed that serum level of Cyst-C had significant correlation with CE（ OR=8.98;95% CI 1.051-8.677）.Conclusion The changes in the levels of serum Cyst-C,beta 2-MG may be risk factor of cerebral infarction.The serum Cyst-C varied with different subtypes of cerebral infarction,specially elevating in the subtype of CE,which indicates that the serum Cyst-C is possibly connected with etiology of cerebral infarction.