胱抑素C对脑卒中高危人群心血管事件的预测价值

Predictive Value of Cystatin C on Cardiovascular Events in High Risk Population of Stroke

目的在脑卒中高危人群中,探讨血清胱抑素C(cystatin C,Cys C)对心血管事件的早期预测价值。方法 2013年4月从杭州市朝晖街道筛查出脑卒中高危人群677例,收集其血清Cys C及其他临床资料。根据血清Cys C水平,将入选者分为4组:Q1(Cys C<0.830mg/L)、Q2(0.830mg/L≤Cys C<0.940mg/L)、Q3(0.940mg/L≤Cys C≤1.060mg/L)和Q4(Cys C>1.060mg/L)。并在随后两年观察其是否发生不良心血管事件,通过单因素分析和Logistic多因素回归分析对不良心血管事件危险因素进行统计学分析。结果 42例(发生率6.2%)发生不良心血管事件。与无不良心血管事件组比较,发生不良心血管事件组血清Cys C、年龄和心脏病史比例明显升高(P<0.05),与Q1组比较,Q4组发生不良心血管事件的比例明显升高(P<0.05)。Logistic多因素回归分析,结果显示血清Cys C、心脏病史、脑卒中家族史是发生不良心血管事件独立危险因素。与Q1组比较,Q4组发生不良心血管事件是Q1组的5.143倍(OR=5.143,95%CI:1.831~14.444,P=0.002)。结论血清Cys C水平是早期判断脑卒中高危人群发生不良心血管事件的独立预测因子。

Objective To investigate the early predictive value of serum cystatin C （Cys C） on cardiovascular events in high-risk population of stroke. Methods Six hundred and seventy-seven cases of patients with high risk of stroke from Zhaohui Street of Hangzhou city were screened in April 2013. The serum Cys C and other clinical data were collected.According to the serum Cys C level, patients were divided into four groups：group Q1 （Cys C〈0.830mg/L）, group Q2 （0.830mg/L ≤ Cys C〈0.940mg/L）, group Q3（0.940mg/L ≤ Cys C ≤ 1.060mg/L）and group Q4（Cys C〉1.060mg/L）. Followed up for two years, single factor analysis and multivariate Logistic regression analysis were used to analyze the risk factors of adverse cardiovascular events. Results Forty-two cases （6.2%） patients occurred adverse cardiovascular events. The levels of serum Cys C, age and the rates of history of heart disease in adverse cardiovascular events group were significantly higher than those in no adverse cardiovascular events group （P〈0.05）. The incidences of adverse cardiovascular events in Q4 were significantly higher than those in Q1 （P〈0.05）.Logistic multivariate regression revealed that serum Cys C level, history of heart disease, family history of stroke remained the independent risk factors of adverse cardiovascular events. The relative risk of adverse cardiovascular events in Q4 was 5.143 times （OR=5.143, 95%CI：1.831-14.444, P=0.002） higher than Q1. Conclusion Serum Cys C level is an independent predictor of early occurrence of adverse cardiovascular events in patients with high risk of stroke.