ICU急性大面积脑梗死患者血清胱抑素C水平与梗死后认知功能障碍的相关性研究

Study on the Correlation between Serum Cystatin C Level and Cognitive Impairment in Patients with Acute Massive Cerebral Infarction in ICU

目的 探讨胱抑素C(Cys C)水平与急性大面积脑梗死(AMCI)后认知功能障碍(CI)的关系。方法 回顾性收集2017-2019年北票市中心医院收治的AMCI患者137例,依据蒙特利尔认知功能评估量表(MoCA)评估结果分为CI组49例与非CI组88例。比较两组患者的临床资料及Cys C检测结果;对Cys C水平与MoCA评分进行相关性分析;采用Logistic多元回归法对CI发生的相关因素进行分析。结果 两组合并糖尿病、合并高血压、肌酐、尿素氮及肾小球滤过率差异均有统计学意义(P<0.05)。Cys C水平与MoCA评分呈负相关关系( P<0.05)。合并糖尿病、肌酐、肾小球滤和Cys C水平与CI发生密切相关(P<0.05)。结论 Cys C是AMCI后发生CI的相关危险因素,即Cys C水平越高CI越严重,临床可以考虑将其作为预测CI的指标之一。

Objective To investigate the relationship between cystatin C (Cys C) level and cognitive impairment (CI) after acute massive cerebral infarction (AMCI). Methods Atotal of 137 AMCI patients admitted to our hospital from 2017 to 2019 were retrospectively collected. According to the results of the Montreal Cognitive Function Assessment Scale (MoCA), all patients were divided into CI group (N=49 patients) and non-CI group (N=88 patients). The clinical data and Cys C test results of the two groups were compared. The correlation between Cys C level and MoCA score was analyzed. The related factors of CI were analyzed by Logistic multivariate regression method. Results There were significant differences in diabetes mellitus complication, hypertension complication, creatinine, urea nitrogen and glomerular filtration rate between the two groups (P<0.05). Cys C level was negatively correlated with MoCA score (P<0.05). The levels of diabetes mellitus, creatinine, glomerular filtration and Cys C were closely related to the occurrence of CI (P<0.05). Conclusion Cys C is a risk factor for CI after AMCI, that is, the higher the level of Cys C, the more serious CI is. It can be considered as one of the indicators for predicting CI in clinic.