胱抑素C在预测脑卒中高危人群心血管事件的临床应用价值

Clinical value of cystatin C in predicting cardiovascular events in high risk stroke patients

目的探讨血清胱抑素C(cystatin C,Cys C)在脑卒中高危人群中预测早期心血管事件的临床应用价值。方法选取2017年2月至2017年12月从化区街口街社区卫生服务中心脑卒中筛查中高危人群377例,收集其相关临床资料。根据血清Cys C水平分成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>1.060 mg/L)。并在随后的1年中观察其心血管不良事件的发生情况,且以Logistic回归分析不良心血管事件的危险因素。结果377例筛查对象中有42例(11.14%)发生不良心血管事件。发生不良心血管事件组患者的血清Cys C水平较无不良心血管事件组升高,且其年龄和心脏病史比例明显较无不良心血管事件升高,差异均有统计学意义(P<0.05);Q4组不良心血管事件的发生率为20.43%明显较Q1组(5.43%)高,差异有统计学意义(P<0.05);Logistic多因素回归分析,结果显示:血清Cys C、心脏病史和脑卒中家族史为不良心血管事件发生独立危险因素。Q4组的血清Cys C水平在4组中最高,且是最低Q1组的5.145倍(OR=5.145,95%CI:1.833~14.435,P=0.002)。结论血清Cys C可作为脑卒中高危人群早期预测不良心血管事件的独立预测因子。

Objective To explore the clinical value of serum cystatin C(Cys C) in predicting early cardiovascular events in high-risk population of stroke.Methods From February 2017 to December 2017,377 high-risk population of stroke screening in Conghua Jiekou Street community health service centers were selected to collect relevant clinical data.According to the level of serum Cys C,they were divided into four groups:Q1(Cys C<0.830 mg/L),Q2(0.830 mg/L<Cys C<0.940 mg/L),Q3(0.940 mg/L<Cys C<1.060 mg/L) and Q4(Cys C>1.060 mg/L).The occurrence of adverse cardiovascular events was observed in the following year,and the risk factors of adverse cardiovascular events were analyzed by logistic regression.Results 42 out of 377 screening subjects(11.14%) had adverse cardiovascular events.The serum Cys C level in patients with adverse cardiovascular events was higher than that in patients without adverse cardiovascular events,and the proportion of age and heart disease history was significantly higher than that in patients without adverse cardiovascular events(P<0.05).The incidence of adverse cardiovascular events in Q4 group was 20.43% higher than that in Q1 group(5.43%).Statistical significance(P<0.05);Logistic multivariate regression analysis showed that serum Cys C,heart disease history and family history of stroke were independent risk factors for adverse cardiovascular events.The serum Cys C level of Q4 group was the highest among the four groups,and was 5.145 times higher than that of the lowest Q1 group(OR=5.145,95% CI:1.833-14.435,P= 0.002).Conclusion Serum Cys C can be used as an independent predictor for early prediction of adverse cardiovascular events in high risk stroke patients.