血清胱抑素C水平与急性缺血性脑卒中患者脑部大动脉狭窄的关系研究

Relationship between Serum Cystatin C Level and Cerebral Aortic Stenosis in Patients with Acute Ischemic Stroke

目的探讨血清胱抑素C(Cys C)水平与急性缺血性脑卒中(AIS)患者脑部大动脉狭窄的关系,为AIS早期诊断提供参考。方法选取2014—2017年江汉大学附属医院收治的AIS患者210例,根据大脑数字减影血管造影(DSA)检查及脑部大动脉狭窄情况分为正常组109例和狭窄组101例。比较两组患者一般资料(包括年龄、性别、吸烟史、高血压病史、糖尿病病史、血脂异常发生情况、血压)、实验室检查指标[包括血钙及血清Cys C、C反应蛋白(CRP)、肌酐、尿酸、同型半胱氨酸(Hcy)水平];血清Cys C水平与AIS患者脑部大动脉狭窄的关系分析采用多因素Logistic回归分析。结果两组患者年龄、性别、吸烟史、高血压病史、糖尿病病史、血脂异常发生率、收缩压及血清CRP、尿酸、Hcy水平比较,差异无统计学意义(P>0.05);狭窄组患者舒张压、血钙及血清Cys C、肌酐水平高于正常组(P<0.05)。多因素Logistic回归分析结果显示,血清Cys C水平是AIS患者脑部大动脉狭窄的影响因素[OR=2.333,95%CI(2.319,2.346),P<0.05]。结论血清Cys C水平是AIS患者脑部大动脉狭窄的影响因素,血清Cys C水平升高可导致AIS患者脑部大动脉狭窄发生风险升高。

Objective To investigate the relationship between serum cystatin C level and cerebral aortic stenosis in patients with acute ischemic stroke.Methods A total of 210 patients with acute ischemic stroke were selected in the Affiliated Hospital of Jianghan University from 2014 to 2017,and they were divided into normal group(n=109)and stenosis group(n=101)according to the cerebral DSA examination results and incidence of cerebral aortic stenosis.General information(including age,gender,history of smoking,hypertension and diabetes,incidence of dyslipidemia and blood pressure)and laboratory examination results(including blood calcium cystatin C,CRP,Cr,UA and Hcy)were compared between the two groups;multivariate Logistic regression analysis was used to analyze the relationship between serum cystatin C level and cerebral aortic stenosis in patients with acute ischemic stroke.Results No statistically significant differences of age,gender,history of smoking,hypertension or diabetes,incidence of dyslipidemia,SBP,serum level of CRP,UA or Hcy was found between the two groups(P>0.05),while DBP,blood calcium,serum levels of cystatin C level and Cr in stenosis group were statistically significantly higher than those in normal group(P<0.05).Multivariate Logistic regression analysis results showed that,serum cystatin C level was one of influencing factors of cerebral aortic stenosis in patients with acute ischemic stroke〔OR=2.333,95%CI(2.319,2.346),P<0.05〕.Conclusion Serum cystatin C level is one of influencing factors of cerebral aortic stenosis in patients with acute ischemic stroke,elevation of serum cystatin C level may increase the risk of cerebral aortic stenosis.