脑梗死患者Cys⁃C、UA 及Hcy 水平与预后相关性分析

Correlation of Cys⁃C,UA and Hcy levels and prognosis in patients with cerebral infarction

目的分析脑梗死患者胱抑素C(Cys⁃C)、尿酸(UA)及血同型半胱氨酸(Hcy)水平与预后相关性。方法选取2020年1月至2022年2月涡阳县人民医院收治脑梗死患者153例为研究对象,根据国立卫生研究院卒中量表(NIHSS)分为轻度损伤组(NIHSS评分<3分)57例,中度损伤组(NIHSS评分3~10分)61例;重度损伤组(NIHSS评分>10分)35例。治疗后,使用格拉斯哥预后评分量表(GOS)评估预后情况并分组,GOS 1~3分为预后不良组,GOS 4~5分为预后良好组;对比不同神经功能损伤的Cys⁃C、UA及Hcy水平;对比不同预后情况基线资料及临床特征,采用多元Logistic回归分析影响脑梗死预后的危险因素。结果Cys⁃C、UA及Hcy水平:重度损伤组>中度损伤组>轻度损伤组,差异具有统计学意义(P<0.05)。预后不良组41例,预后良好组112例。两组年龄、性别、饮酒、高血压、糖尿病、冠心病等既往史、中性细胞、淋巴细胞、血小板、收缩压、舒张压水平比较差异无统计学意义(P>0.05)。两组吸烟、大面积脑梗死、Cys⁃C、UA及Hcy水平比较差异有统计学意义(P<0.05)。多元Logistic回归分析结果显示,吸烟、大面积梗死、Cys⁃C、UA及Hcy水平是影响脑梗死预后的的独立危险因素(P<0.05)。结论脑梗死患者Cys⁃C、UA及Hcy水平异常升高,三者与患者预后具有紧密联系,对评估预后具有一定参考价值。

Objective To analyze the correlation between the levels of cystatin C(Cys⁃C),uric acid(UA)and blood homocysteine(Hcy)and prognosis in patients with cerebral infarction.Methods 153 patients with cerebral infarction admitted to our hospital from January 2020 to February 2022 were selected as the research subjects,and according to the National Institutes of Health Stroke Scale(NIHSS),they were di⁃vided into the mild injury group(NIHSS score<3 points)with 57 cases,the moderate injury group(NIHSS score 3⁃10 points)with 61 cases;the severe injury group(NIHSS score>10 points)with 35 cases.After treat⁃ment,Glasgow Outcome Scale(GOS)was used to evaluate the prognosis and divide the patients into groups.GOS1⁃3 was divided into the poor prognosis group and the GOS4⁃5 was divided into the good prognosis group;The levels of Cys⁃C,UA and Hcy in different neurological injuries were compared.The baseline data and clinical characteristics of different prognosis were compared,and the risk factors affecting the prognosis of cerebral infarction were analyzed by multiple logistic regression.Results The levels of Cys⁃C,UA and Hcy:severe injury group>moderate injury group>mild injury group,the difference was statistically significant(P<0.05).41 patients had poor prognosis and 112 patients had good prognosis;There were no significant dif⁃ferences in age,gender,drinking,hypertension,diabetes,coronary heart disease and other history,neutro⁃phils,lymphocytes,platelets,systolic blood pressure and diastolic blood pressure between the poor prognosis group and the improved prognosis group(P>0.05).There were significant differences in smoking,massive cerebral infarction,Cys⁃C,UA and Hcy levels between the two groups(P<0.05).Multivariate Logistic regres⁃sion analysis showed that smoking,large area infarction,Cys⁃C,UA and Hcy levels were independent risk factors affecting the prognosis of cerebral infarction(P<0.05).Conclusion The abnormally elevated levels of Cys⁃C,UA and Hcy in patients with cerebral infarction are closely related to the prognosis,and have cer⁃tain reference value for evaluating the prognosis.