胱抑素C水平与急性脑梗死神经功能缺损评估及预后相关研究

Cystatin C level and nerve function restoration in patients with acute cerebral infarction

目的:研究血清胱抑素C水平与急性脑梗死神经功能缺损及其对患者神经功能恢复的影响。方法:选取芜湖市第一人民医院2017年1月~2018年6月诊断为急性脑梗死患者91例。对入院病例采集病史,根据美国国立卫生研究院卒中量表(NIHSS)进行评分,分为低缺损组46例,高缺损组45例;根据日常生活活动能力量表进行评分,分为能力不良组34例,能力良好组57例。根据不同评分比较患者的血尿酸、同型半胱氨酸及血清胱抑素C水平。结果:高缺损组患者同型半胱氨酸、胱抑素C水平均高于低缺损组(P<0.05),而两组患者尿酸水平差异无统计学意义(P>0.05)。能力不良组尿酸、胱抑素C水平均高于能力良好组(P<0.05),而两组患者同型半胱氨酸水平差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,胱抑素C水平增高(OR=6.013)是脑梗死神经功能缺损的危险因素,胱抑素C水平增高(OR=9.043)是脑梗死预后不良的危险因素。结论:高胱抑素C水平是急性脑梗死神经功能缺损的相关因素,并可用来评估急性脑梗死患者的日常生活能力预后情况。

Objective:To observe the effect of serum cystatin C level on neurologic function impairment degree and nerve function restoration in patients with acute cerebral infarction.Methods:Ninety-one patients with acute cerebral infarction diagnosed in Wuhu No.1 People′s Hospital were included from January 2017 to June 2018,and the case history on admission was collected.All cases were divided into low neurologic defect group(n=46)and high defect group(n=45)by the National Institutes of Health Stroke Scale(NIHSS),and further allocated to group of poor ability of daily living(n=34)and good ability of daily living(n=57)according to the Barthel index.The levels of serum uric acid,homocysteine and serum cystatin C were compared by different scoring in the groups described above.Results:The average level of homocysteine and cystatin C was higher in the high defect group than in the low defect group(P<0.05),yet the difference was insignificant in uric acid level between the two groups(P>0.05).Patients with poor ability of daily living had higher level of homocysteine and cystatin C than those with good daily living ability(P<0.05),whereas homocysteine level remained no difference between groups(P>0.05).Multivariate logistic regression analysis showed that elevated cystatin C level was the risk factor(OR=6.013)leading to neurological impairment and poor prognosis(OR=9.043)in patients following acute cerebral infarction.Conclusion:Higher cystatin C level is involved in neurological defect in patients with acute cerebral infarction,and an indicator to predict the prognosis of ability of daily living in such victims.