血清胱抑素-C水平在轻度认知功能损害中的作用

The effect of serum cystatin- C level on mild cognitive impairment

目的探讨血清胱抑素C水平在轻度认知功能损害发生中的作用。方法选择2013~2015年于齐齐哈尔医学院附属第三医院就诊的患者273例,分为MCI组与对照组,检测血清胱抑素C水平、认知功能评分,调整可能的影响因素,分析血清胱抑素C水平与MCI发生的关系。结果不同胱抑素C水平组中年龄、高血压、糖尿病、吸烟、饮酒、血脂异常、肌酐结果异常情况分布差异有统计学意义（P〈0.05）;MCI组血清胱抑素C水平（0.727±0.082）mg/L与对照组（0.514±0.045）mg/L差异有统计学意义（t=23.68,P〈0.01）。MCI组血清胱抑素C水平与MMSE得分（r=-0.318）、MOCA得分（r=-0.572）均存在负相关（P〈0.05）,随着血清胱抑素C水平的升高,MCI患病的发生率升高（χ~2=13.12,P〈0.01）;不同血清Cys-C水平患者MCI患病风险的多因素Logistic回归分析显示高血清胱抑素C水平（OR=15.675,95%CI：3.184~55.257,P=0.001）、糖尿病史（OR=2.986,95%CI：1.691~6.435,P=0.03）、教育年限（OR=0.863,95%CI：0.265~3.298,P=0.03）、吸烟（OR=3.324,95%CI：0.512~16.475,P=0.17）、饮酒史（OR=5.452,95%CI：1.072~21.547,P=0.03）、血脂异常（OR=3.457,95%CI：1.199~9.252,P=0.02）是导致MCI的独立危险因素。结论高Cys-C水平与轻度认知功能损害发生风险密切相关。

Objective To investigate the role of serum cystatin- C level in the occurrence of mild cognitive impairment. Methods Tested the level of Cys- C and the score of cognitive impairment for 273 cases those who were divided into MCI group and control group,the patients hospitalized in the third affiliated hospital of Qiqihar Medical College during the year 2013 to 2015. Arrange the possible influence factors to investigate the correlation between Cys- C level and mild cognitive impairment. Results With different Cys- C level,the distribution of age,the history of smoking and drinking,diabetes,high blood pressure,anomaly blood fat,anomaly creatinine are significantly different（ P 0. 05）. The level of Cys- C in MCI group was significantly different from the control group[（ 0. 727 ± 0. 082） mg / L vs（ 0. 514 ± 0. 045） mg / L,t = 23. 68,P 0. 01]. The level of Cys- C in MCI group was negatively correlated with MMSE（ r =- 0. 318） and MOCA（ r =- 0. 572）.The level of Cys- C raised,the incidence of MCI increased（ χ~2= 13. 12,P 0. 01）. Logistic regression analysis showed that different level of Cys- C（ OR = 15. 675,95% CI： 3. 184 ~ 55. 257,P = 0. 001）,diabetes（ OR = 2.986,95% CI： 1. 691 ~ 6. 435,P = 0. 03）,standard of culture（ OR = 0. 863,95% CI： 0. 265 ~ 3. 298,P = 0.03）,the history of smoking（ OR = 3. 324,95% CI： 0. 512 ~ 16. 475,P = 0. 17） and drinking（ OR = 5. 452,95% CI： 1. 072 ~ 21. 547,P = 0. 03） and blood fat（ OR = 3. 457,95% CI： 1. 199 ~ 9. 252,P = 0. 02） were the independent risk factors of MCI. Conclusions High serum cystatin- C level is closely correlated with the occurrence risk of mild cognitive impairment.