血清胱抑素C和同型半胱氨酸与颈动脉粥样硬化及脑梗死的相关性研究

Study on the relationship between serum cystatin C,homocysteine and carotid atherosclerosis and cerebral infarction

目的探讨胱抑素C(Cys-C)、同型半胱氨酸(Hcy)与脑梗死及颈动脉粥样硬化的相关性。方法选取2017年1月至2019年8月于本院神经内科住院治疗的289例患者作为研究对象,其中脑梗死患者作为观察组(n=150),非脑梗死患者作为对照组(n=139),两组均行颈动脉多普勒超声和血生化检查。根据颈动脉多普勒超声检查将所有研究对象进一步分为颈动脉内中膜正常组(n=84)、颈动脉内中膜增厚组(n=48)与斑块亚组(n=157)。根据Cys-C的四分位数将所有研究对象分为Q1(0~0.77 mg/L)、Q2(>0.77~0.88 mg/L)、Q3(>0.88~1.04 mg/L)、Q4(>1.04 mg/L)。结果观察组Cys-C、Hcy、颈动脉内中膜厚度均高于对照组(P<0.05)。颈动脉内中膜增厚组Cys-C水平高于颈动脉内中膜正常组(P<0.05),斑块亚组Cys-C水平高于颈动脉内中膜正常组(P<0.05),颈动脉内中膜增厚组、颈动脉内中膜正常组、斑块亚组血清Hcy比较差异无统计学意义,但斑块亚组Hcy高于颈动脉内中膜正常组和颈动脉内中膜增厚组。Cys-C四分位数分组下年龄、尿素氮、肌酐、高密度脂蛋白、Hcy、右颈动脉内中膜厚度、左颈动脉内中膜厚度比较差异有统计学意义(P<0.05)。Q2、Q3、Q4组年龄、左颈动脉内中膜厚度、右颈动脉内中膜厚度均高于Q1组(P<0.05),且随着Cys-C水平升高,年龄逐渐增加,左右颈动脉内中膜厚度逐渐增加。结论Cys-C和Hcy是颈动脉粥样硬化及脑梗死的危险因素,且Cys-C水平与颈动脉内中膜厚度具有相关性。

Objective To investigate the correlation between serum cystatin C(Cys-C),homocysteine(Hcy)and cerebral infarction and carotid atherosclerosis.Methods 289 patients hospitalized in the Department of Neurology of our hospital from January 2017 to August 2019 were selected as the research subjects,patients with cerebral infarction as the observation group(n=150)and patients without cerebral infarction as the control group(n=139).Carotid Doppler ultrasound and blood biochemistry were performed in two groups.According to carotid Doppler ultrasound,all subjects were further divided into normal carotid intima-media group(n=84),carotid intima-media thickening group(n=48)and plaque sub group(n=157).According to the quartile of Cys-C,all subjects were divided into Q1(0-0.77 mg/L),Q2(0.77-0.88 mg/L),Q3(0.88-1.04 mg/L)and Q4(>1.04 mg/L).Results Cys-C,Hcy and carotid intima-media thickness in the observation group were higher than those in the control group(P<0.01).The level of Cys-C in carotid intima-media thickening group was higher than that in normal carotid intima-media group(P<0.05),and the level of Cys-C in plaque sub group was higher than that in normal carotid intima-media group(P<0.05).There was no significant difference in serum Hcy among carotid intima-media thickening group,normal carotid intima-media group and plaque sub group.However,Hcy in plaque sub group was higher than that in normal carotid intima-media group and carotid intima-media thickening group.There were significant differences in age,urea nitrogen,creatinine,high density lipoprotein,Hcy,right carotid intima-media thickness,and left carotid intima-media thickness under CysC quartile groups(P<0.05).The age,left carotid intima-media thickness,and right carotid intima-media thickness in the Q2,Q3,and Q4 groups were all higher than those in the Q1 group(P<0.05).With increasing age,the intima-media thickness of the left and right carotid arteries gradually increased.Conclusion Cys-C and Hcy are risk factors for carotid atherosclerosis and cerebral infarction,and the level of Cys-C is related to carotid intima-media thickness.