血清胱抑素C、尿酸、同型半胱氨酸与急性脑梗死患者颈动脉粥样硬化斑块的相关性分析

Analysis on the correlation between serum cystatin C, uric acid,homocysteine and carotid atherosclerotic plaques in patients with acute cerebral infarction

目的 检测比较急性脑梗死与普通人群的血清胱抑素C(Cys C)、尿酸(UA)、同型半胱氨酸(Hcy)水平,分析急性脑梗死患者颈动脉粥样硬化斑块与Cys C、UA、Hcy的相关性。方法 回顾性选取南方医科大学第七附属医院于2020年9月至2021年9月收治的急性脑梗死患者123例作为观察组,另选择健康体检者100例作为对照组,均取静脉血测定血清Cys C、UA、Hcy,彩色多普勒超声测定颈动脉内中膜厚度(IMT),比较两组各检测指标水平,并比较观察组不同颈动脉粥样硬化程度患者各指标水平,分析各血清指标与颈动脉粥样硬化程度的关系。结果 观察组患者三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、Cys C、UA、Hcy高于对照组,高密度脂蛋白(HDL-C)低于对照组,差异有统计学意义(P <0.05)。不同颈动脉硬化程度的血脂指标比较,差异均无统计学意义(P> 0.05);内膜正常组与内膜增厚组血清Cys C、UA、Hcy水平比较,差异有统计学意义(P <0.05);内膜正常组IMT与血清Cys C、UA、Hcy不相关(P> 0.05);内膜增厚组及斑块形成组IMT与血清Cys C、UA、Hcy水平呈正相关(P <0.05)。结论 急性脑梗死患者颈动脉粥样硬化斑块与血清Cys C、UA、Hcy水平存在密切关联,血清Cys C、UA、Hcy水平越高,发生颈动脉粥样硬化斑块的风险越高。

Objective Serum cystatin C(Cys C), uric acid(UA) and homocysteine(Hcy) levels in acute cerebral infarction patients were compared with those in the general population, and the correlation between carotid atherosclerotic plaque and Cys C, UA and Hcy in acute cerebral infarction patients was analyzed.Methods A total of 123 patients with acute cerebral infarction admitted to the Seventh Affiliated Hospital of Southern Medical University from September 2020 to September 2021 were retrospectively selected as the observation group, and another 100 healthy subjects with physical examination were selected as the control group. The venous blood of all subjects was collected to determine serum Cys C, UA, and Hcy, and color Doppler ultrasound was adopted to measure the carotid intima-media thickness(IMT), and the levels of all testing indicators were compared between the two groups. The levels of all testing indicators were compared among patients with different degrees of carotid atherosclerosis in the observation group, and the correlation between each serum indicator and the degree of carotid atherosclerosis was analyzed. Results The levels of triglycerides(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), Cys C, UA, Hcy were higher and highdensity lipoprotein cholesterol(HDL-C) was lower in the observation group than those in the control group, with statistically significant differences(P < 0.05). There were no statistically significant differences among patients with different degrees of carotid atherosclerosis in terms of lipid indicators(P > 0.05). There were statistically significant differences between those patients with normal intima group and those with thickened intima group in serum Cys C, UA and Hcy levels(P < 0.05). IMT was not correlated with serum Cys C, UA and Hcy in normal intima group(P > 0.05);IMT was positively correlated with serum Cys C, UA and Hcy levels in normal intima group and plaque formation group(P < 0.05). Conclusion Carotid atherosclerotic plaque in patients with acute cerebral infarction is closely related to the levels of serum Cys C, UA and Hcy. The higher the levels of serum Cys C, UA and Hcy, the higher the risk of carotid atherosclerotic plaque.