脑梗死患者Cysc、Hcy水平与疾病严重程度及预后的关系

Relationship of Cysc and Hcy levels with disease severity and prognosis in patients with cerebral infarction

目的探讨脑梗死患者胱抑素C(Cysc)、同型半胱氨酸(Hcy)水平与疾病严重程度以及预后的关系。方法选取脑梗死患者110例,运用神经功能缺损程度评分(NIHSS)评定患者脑梗死严重程度,根据评分结果将其分为3组,其中轻型缺损(A组)55例,中型缺损(B组)41例,重型缺损(C组)14例;预后效果采用改良Rankin量表进行统计,根据评分结果分为良好组59例、不良组51例。于病发第2、14天时采用免疫比浊法测定所有患者的Cysc、Hcy水平,同时对Cysc、Hcy水平与疾病严重程度及预后的关系进行相关性分析。结果脑梗死患者病发第14天Cysc、Hcy水平低于病发第2天水平;C组患者Cysc、Hcy水平明显高于A、B组(P<0.05),3组两两比较差异有统计学意义(P<0.05);良好组Cysc、Hcy水平明显低于不良组(P<0.05);Cysc、Hcy水平与疾病严重程度呈正相关(P<0.05),与预后情况呈负相关(P<0.05)。结论 Cysc、Hcy水平与疾病严重程度及预后具有一定相关性,在患者病情进展预测方面具有一定的参考价值。

Objective To investigate the relationship of Cystatin C （Cysc） and Homocysteine （Hcy） levels with disease severity and prognosis in patients with cerebral infarction （CI）. Methods One hundred and ten patients with CI treated in our hospital were enrolled in the study. According to the disease severity assessed by neurological deficit score （NIHSS）, 55 cases were classified as mild deficiency （group A）, 41 cases as moderate deficiency （group B） and 14 cases as severe deficiency （group C）. The prognosis was evaluated by modified Rankin scale, 59 patients had good prognosis and 51 had poor prognosis. The Cysc and HCY levels were measured with immunoturbidimetry method at d2 and d14 after infarction onset, and the relationship of Cysc and Hcy levels with disease severity and prognosis was analyzed. Results Cysc and Hcy levels at d14 were significantly lower than those at d2 after disease onset （P〈0.05）. Cysc and Hcy levels in group C were significantly higher than those in group A and group B （P〈0.05）, Cysc and Hcy levels in group B were significantly higher than those in group C （P〈 0.05）. Cysc and Hcy levels in patients with good prognosis were significantly lower than in those with poor prognosis （P〈0.05）. Cysc and Hcy levels were positively correlated with disease severity （P〈0.05）, and negatively correlated with prognosis （P〈0.05）. Conclusion Cysc and Hcy levels are correlated with disease severity and prognosis, and it has certain value in evaluation of disease progression.